Nicole Rochelle Tucker, | |
14031 Del Webb Blvd, Summerfield, FL 34491-7957 | |
(352) 433-0091 | |
Not Available |
Full Name | Nicole Rochelle Tucker |
---|---|
Gender | Female |
Speciality | Physical Therapy |
Experience | 14 Years |
Location | 14031 Del Webb Blvd, Summerfield, Florida |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558674762 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT020728 (Pennsylvania) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Innovative Therapies Group Inc | 2769549104 | 4 |
Rose Wellness Clinic Llc. | 6406167733 | 6 |
Provider Name | Innovative Therapies Group Inc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1174768360 PECOS PAC ID: 2769549104 Enrollment ID: O20090330000331 |
Provider Name | Rose Wellness Clinic Llc. |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1598159576 PECOS PAC ID: 6406167733 Enrollment ID: O20150612001402 |
Mailing Address | Practice Location Address |
---|---|
Nicole Rochelle Tucker, 7 Ring Street, Rural Ridge, PA 15075 Ph: () - | Nicole Rochelle Tucker, 14031 Del Webb Blvd, Summerfield, FL 34491-7957 Ph: (352) 433-0091 |
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