Noella Puwol
Individual provider Active NPI Physical Therapist · Tavares, FL
NPI 1609433200 · NPPES record last updated May 20, 2019
Key facts
- NPI
- 1609433200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 34600 (FL)
- Practice address
- 15745 Dora Ave Ste B
Tavares, FL 32778-4943 - Phone
- (352) 357-8358
- NPI assigned
- May 20, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 34600 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cora Health Services Inc | Past | Accepting new patients | |
| Cora Health Services, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 34600 | FL | Yes |
Addresses
Primary practice location
15745 Dora Ave Ste B
Tavares, FL 32778-4943
Mailing address
2530 Citrus Tower Blvd Apt 17103
Clermont, FL 34711-6920
Phone (954) 661-3522
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- R.G. Therapy Services Inc. Dba: Legacy Home Health
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- Mokhtar Khaled Elsayed Radwan
- Radhakrisna Rajulapati
- Bharathi Ramaiah
All providers in Tavares, 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 May 20, 2019. 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.