MEDICARE: MR. ALLAN ANEMAET P.T.

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	PT19062	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT19062	OTHER	FL	PHYSICAL THERAPIST

General Provider Information

NPI Number	:	1275652406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALLAN ANEMAET P.T.

Provider Business Mailing Address
First Line	:	11610 116TH ST
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33778-3035
Country	:	US
Telephone Number	:	727-391-9157
Fax Number	:

Provider Business Practice Location Address
First Line	:	1244 S PINELLAS AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-3720
Country	:	US
Telephone Number	:	727-939-3015
Fax Number	:	727-943-7013

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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