Provider Demographics
NPI:1982816435
Name:VITUG, DONNABELLE
Entity Type:Individual
Prefix:
First Name:DONNABELLE
Middle Name:
Last Name:VITUG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 44TH CT E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-7022
Mailing Address - Country:US
Mailing Address - Phone:941-321-3397
Mailing Address - Fax:941-739-6028
Practice Address - Street 1:6015 44TH CT E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-7022
Practice Address - Country:US
Practice Address - Phone:941-321-3397
Practice Address - Fax:941-739-6028
Is Sole Proprietor?:No
Enumeration Date:2007-05-05
Last Update Date:2007-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9493225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1982816435OtherNPI
FLK8074Medicare PIN
FLU5481AMedicare PIN