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General NPI Number Information
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NPI Number | 1598446650
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Entity Type | Individual
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Provider Name | WILHELM BELMONTE PADLAN PT
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Gender | Male
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 159 N 3RD ST
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City | MACCLENNY
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State | FL
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Zip | 32063-2103
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Country | US
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Telephone | 904-259-3151
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Fax | 904-653-4662
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Provider Business Mailing Address
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Address Line | 5974 LONG COVE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32222-1398
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Country | US
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Telephone | 904-859-1578
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Fax | 904-653-4662
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT10676
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License Number State | FL
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