Individual
EDSEL PAGKANLUNGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3940 RADIO RD, SUITE 109, NAPLES, FL 34104-3740
(239) 643-7879
(239) 643-2951
Mailing address
6825 DAVIS BLVD, APT 157, NAPLES, FL 34104-5331
(239) 643-7879
(239) 643-2951
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0007692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y018N
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
08/28/2007
Last updated
12/28/2016
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