Provider Demographics
NPI:1184638728
Name:NAGLE, IAN (PT)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:NAGLE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8200 S JOG RD
Mailing Address - Street 2:STE 202
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2981
Mailing Address - Country:US
Mailing Address - Phone:561-624-6242
Mailing Address - Fax:305-675-2788
Practice Address - Street 1:8198 S JOG RD STE 207
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-6903
Practice Address - Country:US
Practice Address - Phone:561-740-2045
Practice Address - Fax:561-740-2414
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPT19168208100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation