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General NPI Number Information
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NPI Number | 1659064640
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Entity Type | Individual
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Provider Name | EDWARD PINUELAS PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 1800 E FLORENCE BLVD
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City | CASA GRANDE
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State | AZ
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Zip | 85122-5303
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Country | US
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Telephone | 828-485-4594
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Fax |
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Provider Business Mailing Address
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Address Line | 3719 E HELENA STRA
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City | TUCSON
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State | AZ
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Zip | 85706-1929
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Country | US
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Telephone |
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Fax |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1399766
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | LPT-034044
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License Number State | AZ
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