MEDICARE: ABOVE & BEYOND PLAY, INC

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	OT 0001226	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174943047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE & BEYOND PLAY, INC

Provider Business Mailing Address
First Line	:	35 NW 1ST AVE
Second Line	:
City	:	HIGH SPRINGS
State	:	FL
Zip	:	32643-2653
Country	:	US
Telephone Number	:	352-363-4279
Fax Number	:	386-454-1383

Provider Business Practice Location Address
First Line	:	35 NW 1ST AVE
Second Line	:
City	:	HIGH SPRINGS
State	:	FL
Zip	:	32643-2653
Country	:	US
Telephone Number	:	352-363-4279
Fax Number	:	386-454-1383

Authorized Official
Title or Position	:	OWNER
Name	:	MS. VALERIE GILES EDMANDS
Credential	:	OTR
Telephone Number	:	352-256-5581

Provider Enumeration Date	:	04/18/2014
Last Update Date	:	04/18/2014

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Directions to “ABOVE & BEYOND PLAY, INC ” Practice Location

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