| Doctor Name: | MR. BERNARD AGTUCA AUDITOR |
| NPI Number: | 1265673644 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT019791 |
| Business Practice Address: | 2810 Ruleme St Eustis, FL - 327266527 |
| Business Phone Number: | 3524835037 |
| Business Fax Number: | |
| Mailing Address: | 5705 Quinton Way, Stoneybrook Hills MOUNT DORA |
| State: | FL |
| Postal Code: | 327578030 |
| Phone Number: | 9547981354 |
| Fax Number: | |
| NPI Enumeration Date: | 03/16/2009 |
| NPI Last Update Date: | 09/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT019791 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |