Provider Demographics
NPI:1144416256
Name:BIELE, JANELLE FLORENCE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:FLORENCE
Last Name:BIELE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MRS
Other - First Name:JANELL
Other - Middle Name:FLORENCE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:440 ORIOLE LN
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-4736
Mailing Address - Country:US
Mailing Address - Phone:321-482-4096
Mailing Address - Fax:321-586-2229
Practice Address - Street 1:809 E HIBISCUS BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901
Practice Address - Country:US
Practice Address - Phone:321-327-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 22613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT 22613OtherPHYSICAL THERAPY LICENSE