MEDICARE: DR. GEORGE M ANGALICH DPT

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	225100000X	Physical Therapist	PT003414	WV
2	225100000X	Physical Therapist	PT40765	FL

General Provider Information

NPI Number	:	1952792046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE M ANGALICH DPT

Provider Business Mailing Address
First Line	:	2059 ALTAMONT AVE STE 105
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3281
Country	:	US
Telephone Number	:	239-400-5639
Fax Number	:	866-835-2456

Provider Business Practice Location Address
First Line	:	2059 ALTAMONT AVE STE 105
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3281
Country	:	US
Telephone Number	:	239-400-5639
Fax Number	:	866-835-2456

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

Provider Enumeration Date	:	02/10/2015
Last Update Date	:	05/07/2026

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