MEDICARE: MRS. JANICE R MURPHY PTA

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	225200000X	Physical Therapy Assistant	PTA000047	FL

General Provider Information

NPI Number	:	1356502694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANICE R MURPHY PTA

Provider Business Mailing Address
First Line	:	4430 WHEATLAND WAY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-2661
Country	:	US
Telephone Number	:	727-942-4040
Fax Number	:

Provider Business Practice Location Address
First Line	:	4430 WHEATLAND WAY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-2661
Country	:	US
Telephone Number	:	727-942-4040
Fax Number	:

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

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	06/19/2008

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