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NPI Code Detail

MEDICARE: CAROLYN MARY NUGENT PT

MEDICARE: CAROLYN MARY NUGENT 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 Therapist070015267IL
2225100000XPhysical Therapist36960FL

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 : 1548368046
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN MARY NUGENT PT
Provider Business Mailing Address
First Line : 350 BRADEN AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2001
Country : US
Telephone Number : 941-355-7637
Fax Number :
Provider Business Practice Location Address
First Line : 350 BRADEN AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2001
Country : US
Telephone Number : 941-355-7637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 10/04/2021

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Directions to “ CAROLYN MARY NUGENT PT” Practice Location

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