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General NPI Number Information
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NPI Number | 1659502557
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Entity Type | Individual
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Provider Name | REBECCA STAPLES PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1902 59TH ST W
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City | BRADENTON
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State | FL
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Zip | 34209-4602
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Country | US
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Telephone | 941-761-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 3738 SW PATTON RD
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City | PORTLAND
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State | OR
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Zip | 97221-4128
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Country | US
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Telephone | 503-680-9425
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | PT34189
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License Number State | FL
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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 | 18037
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 63645
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License Number State | OR
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