MEDICARE: HARBOR CITY PHYSICAL THERAPY, PA

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	FLPT18001	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y918X	OTHER	FL	BCBS PROVIDER NUMBER
2	331012	OTHER	FL	WELLCARE PROVIDER NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033243936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBOR CITY PHYSICAL THERAPY, PA

Provider Business Mailing Address
First Line	:	307 E NEW HAVEN AVE
Second Line	:	SUITE 2
City	:	MELBOURNE
State	:	FL
Zip	:	32901-4576
Country	:	US
Telephone Number	:	321-953-3991
Fax Number	:	321-953-3951

Provider Business Practice Location Address
First Line	:	307 E NEW HAVEN AVE
Second Line	:	SUITE 2
City	:	MELBOURNE
State	:	FL
Zip	:	32901-4576
Country	:	US
Telephone Number	:	321-953-3991
Fax Number	:	321-953-3951

Authorized Official
Title or Position	:	OWNER/PT
Name	:	LAWRENCE MICHAEL SHNEYDER
Credential	:	PT
Telephone Number	:	321-953-3991

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	01/24/2024

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Directions to “HARBOR CITY PHYSICAL THERAPY, PA ” Practice Location

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