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NPI Code Detail

MEDICARE: STEPHANIE SEGARRA DPT-PT

MEDICARE:   STEPHANIE  SEGARRA  DPT-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 TherapistPT33031FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130125524OTHERPADRIVER'S LICENSE

General Provider Information

NPI Number : 1215446299
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE SEGARRA DPT-PT
Provider Business Mailing Address
First Line : 14432 MANCHESTER DR
Second Line :
City : NAPLES
State : FL
Zip : 34114-8629
Country : US
Telephone Number : 724-866-9628
Fax Number :
Provider Business Practice Location Address
First Line : 4997 ROYAL GULF CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33966-7006
Country : US
Telephone Number : 239-313-5049
Fax Number : 239-313-5049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2017
Last Update Date : 11/03/2020

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Directions to “ STEPHANIE SEGARRA DPT-PT” Practice Location

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