Provider Demographics
NPI:1801073606
Name:BURNS, PAUL L (PT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:L
Last Name:BURNS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 SWEETWATER CV # 2107
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-4185
Mailing Address - Country:US
Mailing Address - Phone:239-292-0338
Mailing Address - Fax:239-254-9987
Practice Address - Street 1:11341 LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8852
Practice Address - Country:US
Practice Address - Phone:239-591-3456
Practice Address - Fax:239-561-0702
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist