Eugene Paul Bacolod, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

29471 Issued in FL

Practice address

15204 W Colonial Dr
Winter Garden, FL 34787-6042

Phone

(407) 877-2394

NPI assigned

Sep 10, 2019

Sex

Male

Sole proprietor

Yes

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1447809694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 W SMITH ST UNIT 349",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045381",
            "telephone_number": "832-512-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15204 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876042",
            "telephone_number": "407-877-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACOLOD",
        "first_name": "EUGENE PAUL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "29471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hany S Azer, D.D.S.
• Percilla Azizi, M.D.
• Lisa A. Azzizzo
• Ameena Bacchus, PHARM.D.
• Back Aligned Chiropractic, P.a.
• Jenny L Badger, MSPT
• Eldar Bolatovich Baigabatov, M.D.
• Cheryl Bailey Clemens, LMHC
• Lea Evangeline Baker
• Balanced Podiatry, LLC

• Physical Therapy Assistant in Winter Garden, FL
• Providers in Winter Garden, 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 Sep 10, 2019; 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.