MEDICARE: MS. JOYCE A DOYLE PT

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	208100000X	Physical Medicine & Rehabilitation Physician	PT19303	FL
2	225100000X	Physical Therapist	PT19303	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y917Z	OTHER	FL	BCBS GROUP

General Provider Information

NPI Number	:	1366578148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOYCE A DOYLE PT

Provider Business Mailing Address
First Line	:	1700 SE HILLMOOR DRIVE
Second Line	:	SUITE 500
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7536
Country	:	US
Telephone Number	:	772-335-3200
Fax Number	:	877-406-5592

Provider Business Practice Location Address
First Line	:	1700 SE HILLMOOR DRIVE
Second Line	:	SUITE 500
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7536
Country	:	US
Telephone Number	:	772-335-3200
Fax Number	:	877-406-5592

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	10/14/2011

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