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NPI Code Detail

MEDICARE: SAMANTHA CORKWELL PT, DPT

MEDICARE: SAMANTHA CORKWELL PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251N0400XNeurology Physical Therapist31335FL
22251N0400XNeurology Physical Therapist40QA01439300NJ

General Provider Information

NPI Number : 1043741242
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA CORKWELL PT, DPT
Provider Business Mailing Address
First Line : 1875 LAKEMONT AVE APT 303
Second Line :
City : ORLANDO
State : FL
Zip : 32814-6363
Country : US
Telephone Number : 732-754-9742
Fax Number :
Provider Business Practice Location Address
First Line : 5165 ADANSON ST
Second Line :
City : ORLANDO
State : FL
Zip : 32804-1331
Country : US
Telephone Number : 407-303-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2017
Last Update Date : 03/21/2017

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Directions to “ SAMANTHA CORKWELL PT, DPT” Practice Location

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