Joanne Zeidan Agil, PT DPT

Individual provider Active NPI Physical Therapist · Brandon, FL

NPI 1235601634 · NPPES record last updated Oct 12, 2022

Key facts

NPI
1235601634
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT36957 (FL)
Practice address
560 S Lakewood Dr Ste 101
Brandon, FL 33511-5015
Phone
(813) 978-9700
Fax
(813) 588-6187
NPI assigned
Dec 23, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT295993CAMDPhysical Therapist
PT36957FLMDPhysical Therapist

Networks

  • Optimum HealthCare HMO Network

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT295993 CA
Orthopedic Physical Therapist 2251X0800X PT295993 CA
Physical Therapist 225100000X PT36957 FL Yes

Addresses

Primary practice location

560 S Lakewood Dr Ste 101
Brandon, FL 33511-5015

Mailing address

65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone (385) 308-8034

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Other practice location 2

88 Rowland Way Ste 250
Novato, CA 94945-5062
Phone (415) 898-1311

Other names

  • Joanne Zeidan Former name

Other providers in Brandon, FL

All providers in Brandon, FL · Physical Therapist in Florida

Sources for this page

Verify at the official NPI Registry.