MEDICARE: DANIELA JUBIS SACA PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT33292	FL

General Provider Information

NPI Number	:	1003324138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELA JUBIS SACA PT, DPT

Provider Business Mailing Address
First Line	:	14555 SW 82ND AVE
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33158-1403
Country	:	US
Telephone Number	:	201-574-3848
Fax Number	:

Provider Business Practice Location Address
First Line	:	14555 SW 82ND AVE
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33158-1403
Country	:	US
Telephone Number	:	201-574-3848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2018
Last Update Date	:	05/08/2024

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