MEDICARE: PETER BABB

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
1	2251G0304X	Geriatric Physical Therapist	PT13128	FL

General Provider Information

NPI Number	:	1912742255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER BABB

Provider Business Mailing Address
First Line	:	18624 ROYAL HAMMOCK BOULEVARD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-8959
Country	:	US
Telephone Number	:	239-293-4068
Fax Number	:

Provider Business Practice Location Address
First Line	:	18624 ROYAL HAMMOCK BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-8959
Country	:	US
Telephone Number	:	239-293-4068
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2024
Last Update Date	:	06/27/2024

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Directions to “ PETER BABB ” Practice Location

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