Provider Demographics
NPI:1487290953
Name:PAMPILO, FILIPINA RAPUNZEL
Entity type:Individual
Prefix:
First Name:FILIPINA RAPUNZEL
Middle Name:
Last Name:PAMPILO
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 1:1031 GLEN LN
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:GA
Mailing Address - Zip Code:30621-7300
Mailing Address - Country:US
Mailing Address - Phone:850-443-4120
Mailing Address - Fax:
Practice Address - Street 1:1031 GLEN LN
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:GA
Practice Address - Zip Code:30621-7300
Practice Address - Country:US
Practice Address - Phone:850-443-4120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
GAPT008589225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty