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NPI Code Detail

MEDICARE: MISS TAIS FERNANDEZ GIL PTA

MEDICARE: MISS TAIS FERNANDEZ GIL 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
1103K00000XBehavior Analyst1-25-86105FL
2225200000XPhysical Therapy AssistantPTA29923FL

General Provider Information

NPI Number : 1578236055
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TAIS FERNANDEZ GIL PTA
Provider Business Mailing Address
First Line : 2246 NW 7TH PL
Second Line :
City : CAPE CORAL
State : FL
Zip : 33993-4041
Country : US
Telephone Number : 305-303-0392
Fax Number :
Provider Business Practice Location Address
First Line : 3351 MARINATOWN LN STE 200
Second Line : #200
City : NORTH FORT MYERS
State : FL
Zip : 33903-7000
Country : US
Telephone Number : 239-257-1088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2021
Last Update Date : 01/22/2026

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Directions to “ MISS TAIS FERNANDEZ GIL PTA” Practice Location

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