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General NPI Number Information
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NPI Number | 1821914185
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Entity Type | Individual
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Provider Name | ITUMELENG GABASIANE
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Gender | Female
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 06/29/2026
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Provider Practice Location Address
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Address Line | 5867 E COUNTY ROAD 466
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City | THE VILLAGES
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State | FL
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Zip | 32162-3605
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Country | US
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Telephone | 844-502-7996
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Fax |
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Provider Business Mailing Address
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Address Line | 2053 CAROLINA AVE
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City | GOTHA
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State | FL
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Zip | 34734-5026
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Country | US
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Telephone | 269-635-9422
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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 | PT44281
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License Number State | FL
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