MEDICARE: BRIAN JOSEPH PAUTLER

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	PT33857	FL

General Provider Information

NPI Number	:	1992283733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN JOSEPH PAUTLER

Provider Business Mailing Address
First Line	:	8939 SHENANDOAH RUN
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-5463
Country	:	US
Telephone Number	:	813-476-1483
Fax Number	:

Provider Business Practice Location Address
First Line	:	20577 AMBERFIELD DR BLDG 7
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-4323
Country	:	US
Telephone Number	:	813-909-7451
Fax Number	:

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

Provider Enumeration Date	:	08/03/2018
Last Update Date	:	08/03/2018

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Directions to “ BRIAN JOSEPH PAUTLER ” Practice Location

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