Provider Demographics
NPI:1629331244
Name:FIEDLER, NATHANIEL T (DPT, CERT MDT)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:T
Last Name:FIEDLER
Suffix:
Gender:M
Credentials:DPT, CERT MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12975 COLLIER BLVD STE 102A
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-4004
Mailing Address - Country:US
Mailing Address - Phone:239-300-4779
Mailing Address - Fax:
Practice Address - Street 1:12975 COLLIER BLVD STE 102A
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-4004
Practice Address - Country:US
Practice Address - Phone:518-489-2524
Practice Address - Fax:518-489-3167
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT37390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist