Falon Melissa Jimenez Irwin, PT, DPT, CSCS

Individual provider Active NPI Physical Therapist · The Villages, FL

NPI 1306439617 · NPPES record last updated Dec 20, 2022

Key facts

NPI
1306439617
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
39506 (FL)
Practice address
2963 Traverse TRL
The Villages, FL 32163-2017
Phone
(352) 254-3376
NPI assigned
Feb 17, 2021
Sex
Female
Sole proprietor
Yes

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
39506FLMDPhysical Therapist
40QA01993100NJMDPhysical Therapist

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X 40QA01993100 NJ
Physical Therapist 225100000X 39506 FL Yes

Addresses

Primary practice location

2963 Traverse TRL
The Villages, FL 32163-2017

Mailing address

1701 New Rd
Northfield, NJ 08225-1197
Phone (609) 867-9353

Other practice location 1

1701 New Rd
Northfield, NJ 08225-1197
Phone (609) 272-1150

Other providers in The Villages, FL

All providers in The Villages, FL · Physical Therapist in Florida

Sources for this page

Verify at the official NPI Registry.