Provider Demographics
NPI:1992001887
Name:KUGLER, ANNE G (MPR)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:G
Last Name:KUGLER
Suffix:
Gender:F
Credentials:MPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 SOUTHSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8067
Mailing Address - Country:US
Mailing Address - Phone:904-928-1133
Mailing Address - Fax:
Practice Address - Street 1:2329 MARSH LANDING CT
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-7780
Practice Address - Country:US
Practice Address - Phone:904-215-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15606225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist