MEDICARE: MR. ERIC L FRENCH 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	225100000X	Physical Therapist	PT1535	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y900V	OTHER	FL	BLUE SHIELD
2	Y900T	OTHER	FL	BLUE SHIELD
3	Y900U	OTHER	FL	BLUE SHIELD

General Provider Information

NPI Number	:	1417930116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC L FRENCH PT

Provider Business Mailing Address
First Line	:	PO BOX 820
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34220-0820
Country	:	US
Telephone Number	:	941-729-1738
Fax Number	:	941-722-7844

Provider Business Practice Location Address
First Line	:	2010 59TH ST W
Second Line	:	STE 4700
City	:	BRADENTON
State	:	FL
Zip	:	34209-4616
Country	:	US
Telephone Number	:	941-794-3305
Fax Number	:	941-792-8881

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

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	07/08/2007

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