MEDICARE: BUTTERFLY REHABILITATION OF PANAMA CITY

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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)	683201	FL

General Provider Information

NPI Number	:	1457323230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUTTERFLY REHABILITATION OF PANAMA CITY

Provider Business Mailing Address
First Line	:	8075 SW 107TH AVE
Second Line	:	SUITE 306
City	:	MIAMI
State	:	FL
Zip	:	33173-4848
Country	:	US
Telephone Number	:	305-992-2044
Fax Number	:	239-775-1118

Provider Business Practice Location Address
First Line	:	11063 TAMIAMI TRL E
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34113-7718
Country	:	US
Telephone Number	:	305-992-2044
Fax Number	:	239-775-1118

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	MR. ANDY HEMCHAND
Credential	:
Telephone Number	:	305-992-2044

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	01/17/2013

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