Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT33085 | FL |
NPI | 1023524865 |
---|---|
Provider Name | Dr. Joses N Ngugi |
First Address | Tampa, FL 33606-2767 |
Second Address | Tampa, FL 33606-2767 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2017 |
Last Update Date | 17/03/2018 |