MEDICARE: SUMERIAN CORPORATION

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	261QP2000X	Physical Therapy Clinic/Center	PTA 012528	FL

General Provider Information

NPI Number	:	1114237625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMERIAN CORPORATION

Provider Business Mailing Address
First Line	:	1646 W RIVER DR
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-2729
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 W COMMERCIAL BLVD
Second Line	:	SUITE 201
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-2148
Country	:	US
Telephone Number	:	954-722-2212
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. ZEB GARDNER
Credential	:
Telephone Number	:	954-471-6303

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	10/18/2010

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Directions to “SUMERIAN CORPORATION ” Practice Location

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