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General NPI Number Information
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NPI Number | 1568657237
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Entity Type | Individual
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Provider Name | MA NOEMI PAGKANLUNGAN
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Gender | Female
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 12/28/2016
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Provider Practice Location Address
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Address Line | 3940 RADIO RD SUITE 109
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City | NAPLES
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State | FL
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Zip | 34104-3740
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Country | US
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Telephone | 239-643-7879
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Fax |
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Provider Business Mailing Address
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Address Line | 6825 DAVIS BLVD APT 157
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City | NAPLES
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State | FL
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Zip | 34104-5331
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Country | US
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Telephone | 239-643-7879
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Fax | 239-643-2951
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT0008895
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License Number State | FL
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