MEDICARE: JULIA NOGA

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
1	225100000X	Physical Therapist	25535	FL

General Provider Information

NPI Number	:	1114228491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA NOGA

Provider Business Mailing Address
First Line	:	313 N 31ST AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-7005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1491 6TH ST NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-2365
Country	:	US
Telephone Number	:	863-293-7778
Fax Number	:	863-299-3836

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2010
Last Update Date	:	11/03/2010

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Directions to “ JULIA NOGA ” Practice Location

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