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NPI Code Detail

MEDICARE: MS. RUTH ELAINE VERGARA BEDONIA P.T.

MEDICARE: MS. RUTH ELAINE VERGARA BEDONIA P.T.
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 Therapist25283FL

General Provider Information

NPI Number : 1558616748
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RUTH ELAINE VERGARA BEDONIA P.T.
Provider Business Mailing Address
First Line : 3050 CHAMPION RING RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33905-5599
Country : US
Telephone Number : 239-313-2900
Fax Number :
Provider Business Practice Location Address
First Line : 3050 CHAMPION RING RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33905-5599
Country : US
Telephone Number : 239-313-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2012
Last Update Date : 02/09/2020

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