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NPI Code Detail

MEDICARE: DANA JENNIFER NOEL PTA

MEDICARE: DANA JENNIFER NOEL PTA
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
1225200000XPhysical Therapy AssistantPTA29264FL

General Provider Information

NPI Number : 1578177093
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA JENNIFER NOEL PTA
Provider Business Mailing Address
First Line : 8477 S SUNCOAST BLVD
Second Line :
City : HOMOSASSA
State : FL
Zip : 34446-5028
Country : US
Telephone Number : 352-382-7214
Fax Number : 352-382-7781
Provider Business Practice Location Address
First Line : 700 SW 4TH ST
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33060-7678
Country : US
Telephone Number : 954-247-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2020
Last Update Date : 08/15/2023

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Directions to “ DANA JENNIFER NOEL PTA” Practice Location

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