MEDICARE: PERFORMANCE PHYSICAL THERAPY OF NAPLES

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	PT7021	FL

General Provider Information

NPI Number	:	1144337452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFORMANCE PHYSICAL THERAPY OF NAPLES

Provider Business Mailing Address
First Line	:	4949 TAMIAMI TRL N
Second Line	:	SUITE 104
City	:	NAPLES
State	:	FL
Zip	:	34103-3027
Country	:	US
Telephone Number	:	239-643-2040
Fax Number	:	239-643-2080

Provider Business Practice Location Address
First Line	:	1201 PIPER BLVD STE 18
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110-1385
Country	:	US
Telephone Number	:	239-593-3010
Fax Number	:	239-593-3010

Authorized Official
Title or Position	:	CREDENTIALING/ BILLING MANAGER
Name	:	YUSI SANCHEZ
Credential	:
Telephone Number	:	239-692-9679

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	11/02/2020

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Directions to “PERFORMANCE PHYSICAL THERAPY OF NAPLES ” Practice Location

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