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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
34600FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cora Health Services Inc Past Accepting new patients
Cora Health Services, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Tavares, FL

All providers in Tavares, FL · Physical Therapist in Florida

Sources for this page

Verify at the official NPI Registry.