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NPI Code Detail

MEDICARE: ROLLYNS BRIGNOL

MEDICARE: ROLLYNS BRIGNOL
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
1225200000XPhysical Therapy Assistant

General Provider Information

NPI Number : 1053889188
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROLLYNS BRIGNOL
Provider Business Mailing Address
First Line : 3250 WINKLER AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-9414
Country : US
Telephone Number : 813-361-4688
Fax Number :
Provider Business Practice Location Address
First Line : 3250 WINKLER AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-9414
Country : US
Telephone Number : 813-361-4688
Fax Number : 847-730-2988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2018
Last Update Date : 11/07/2018

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