MEDICARE: KENNETH GABON ARGUELLES

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

General Provider Information

NPI Number	:	1255044806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH GABON ARGUELLES

Provider Business Mailing Address
First Line	:	3245 ESCAPADE CIR
Second Line	:
City	:	RIVA
State	:	MD
Zip	:	21140-1307
Country	:	US
Telephone Number	:	516-451-9828
Fax Number	:

Provider Business Practice Location Address
First Line	:	7611 CRAIN HWY STE C-170
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-4258
Country	:	US
Telephone Number	:	443-481-1140
Fax Number	:	301-296-3129

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

Provider Enumeration Date	:	12/28/2022
Last Update Date	:	01/18/2023

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Directions to “ KENNETH GABON ARGUELLES ” Practice Location

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