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NPI Code Detail

MEDICARE: MRS. TOM HERTEL PT18995

MEDICARE: MRS. TOM HERTEL PT18995
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 TherapistPT18995FL

General Provider Information

NPI Number : 1598832214
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TOM HERTEL PT18995
Provider Business Mailing Address
First Line : 3305 S ORANGE AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32806-6125
Country : US
Telephone Number : 407-852-3310
Fax Number : 407-852-3301
Provider Business Practice Location Address
First Line : 3305 S ORANGE AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32806-6125
Country : US
Telephone Number : 407-852-3310
Fax Number : 407-852-3301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. TOM HERTEL PT18995” Practice Location

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