Gaetan Gedeon, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA25571 Issued in FL

Practice address

13720 N Cleveland Ave
Suite B
North Fort Myers, FL 33903-4300

Phone

(239) 997-8100

Fax

(239) 997-4817

NPI assigned

Oct 7, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1285005918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13720 N CLEVELAND AVE",
            "address_2": "SUITE B",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339034300",
            "telephone_number": "239-997-8100",
            "fax_number": "239-997-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13720 N CLEVELAND AVE",
            "address_2": "SUITE B",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339034300",
            "telephone_number": "239-997-8100",
            "fax_number": "239-997-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDEON",
        "first_name": "GAETAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA25571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in North Fort Myers, FL
• Providers in North Fort Myers, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.