Pamela Renee Gates, DPT
Individual provider Active NPI Physical Therapist · Indialantic, FL
NPI 1104147958 · NPPES record last updated Sep 13, 2021
Key facts
- NPI
- 1104147958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT- 25556 (FL)
- Practice address
- 1001 S Shannon Ave
Indialantic, FL 32903-3334 - Phone
- (352) 514-2167
- Fax
- (321) 234-7910
- NPI assigned
- Jun 16, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT- 25556 | FL | MD | Physical Therapist |
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gates Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1001 S Shannon Ave
Indialantic, FL 32903
Phone (352) 514-2167
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT- 25556 | FL | Yes |
Addresses
Primary practice location
1001 S Shannon Ave
Indialantic, FL 32903-3334
Mailing address
1001 S Shannon Ave
Indialantic, FL 32903-3334
Phone (352) 514-2167
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT-25556 | Other | FL | STATE OF FLORIDA PT LICENSE NUMBER |
Other names
- Dr. Pamela Renee Callaway
Other providers in Indialantic, FL
- Jean Marie C Fuller
- Patrick Shepard Fuller
- Kimberly Ann Beck Gallaher
- Candice Gallion
- Gates Physical Therapy, LLC
- Jazmine M Gaudet
- Nikolaos Georgios Gavrilis
- Ashton Gelzinis
- Generations on the Beach
- Heather H. Gilotti
All providers in Indialantic, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.