Kenneth Panganiban, PTA is a
Physical Therapy Assistant based in Ponte Vedra Beach, Florida. Kenneth Panganiban is licensed to practice in Florida (license number PTA25367) and his current practice location is
232 Ponte Vedra Park Dr, Ponte Vedra Beach, Florida. He can be reached at his office (for appointments etc.) via phone at
(904) 634-0640.
NPI number for Kenneth Panganiban is 1124418934 and his current mailing address is 10270 Stallion Run Court, Jacksonville, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1124418934.
Healthcare Provider's Profile
| Full Name | Kenneth Panganiban |
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| Gender | Male |
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| Speciality | Physical Therapy Assistant |
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| Location | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1124418934
- Provider Enumeration Date: 02/01/2015
- Last Update Date: 08/11/2017
Medical Identifiers
Medical identifiers for Kenneth Panganiban such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124418934 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225700000X | Massage Therapist | MA59111 (Florida) | Secondary |
| 225200000X | Physical Therapy Assistant | PTA25367 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Panganiban is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kenneth Panganiban, PTA
10270 Stallion Run Court,
Jacksonville, FL 32257
Ph: () - | Kenneth Panganiban, PTA
232 Ponte Vedra Park Dr,
Ponte Vedra Beach, FL 32082-6600
Ph: (904) 634-0640 |
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