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NPI Code Detail

MEDICARE: TEGAN LEIGH NELSON PT

MEDICARE: TEGAN LEIGH NELSON PT
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
1225100000XPhysical Therapist10492MN
2225100000XPhysical TherapistPT35708FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194970251
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEGAN LEIGH NELSON PT
Provider Business Mailing Address
First Line : 2531 CLEVELAND AVE STE 100
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-4900
Country : US
Telephone Number : 239-334-7000
Fax Number : 239-334-7070
Provider Business Practice Location Address
First Line : 2531 CLEVELAND AVE STE 100
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-4900
Country : US
Telephone Number : 239-334-7000
Fax Number : 239-334-7070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2008
Last Update Date : 03/14/2022

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Directions to “ TEGAN LEIGH NELSON PT” Practice Location

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