Doctor Name: | JUDITH DOYOLA NICOLAS |
NPI Number: | 1700145463 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RPT |
License Number: | PT21088 |
Business Practice Address: | 349 Crestrun Loop Leesburg, FL - 347482599 |
Business Phone Number: | 3522178665 |
Business Fax Number: | 3527874743 |
Mailing Address: | 349 Crestrun Loop, LEESBURG |
State: | FL |
Postal Code: | 347482599 |
Phone Number: | 3522178665 |
Fax Number: | 3527874743 |
NPI Enumeration Date: | 05/15/2012 |
NPI Last Update Date: | 05/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT21088 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |