Individual
MADISON MAE SCHANTZ NUGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
120 N RICHARD JACKSON BLVD STE 180, PANAMA CITY BEACH, FL 32407-2522
(850) 235-6360
(850) 235-8871
Mailing address
2937 TEN ACRE RD, PANAMA CITY, FL 32405-7129
(567) 204-1278
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
20716
FL
225XN1300X
Neurorehabilitation Occupational Therapist
20716
FL
225XP0019X
Physical Rehabilitation Occupational Therapist
20716
FL
225XP0200X
Pediatric Occupational Therapist
Primary
20716
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT20716
OCCUPATIONAL THERAPY LICENSE
FL
Enumeration date
02/23/2022
Last updated
03/12/2025
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