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NPI Code Detail

MEDICARE: PAIGE RONCA DPT

MEDICARE: PAIGE RONCA DPT
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 Therapist1266300TX

General Provider Information

NPI Number : 1417318494
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE RONCA DPT
Provider Business Mailing Address
First Line : 728 ALAMEDA ST
Second Line :
City : ORLANDO
State : FL
Zip : 32804-7208
Country : US
Telephone Number : 407-922-3917
Fax Number :
Provider Business Practice Location Address
First Line : 9009 WHITE ROCK TRL
Second Line :
City : DALLAS
State : TX
Zip : 75238-3347
Country : US
Telephone Number : 214-355-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2016
Last Update Date : 03/17/2016

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