MEDICARE: FULVIA PAPASMYRIS PAPASMYRIS

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	MA109441	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA109441	OTHER	FL	LICENSE

General Provider Information

NPI Number	:	1487570164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FULVIA PAPASMYRIS PAPASMYRIS

Provider Business Mailing Address
First Line	:	1530 JFK CAUSEWAY PMB 200
Second Line	:
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141
Country	:	US
Telephone Number	:	786-390-6396
Fax Number	:

Provider Business Practice Location Address
First Line	:	1530 JOHN F KENNEDY CAUSEWAY
Second Line	:	PMB 200
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141
Country	:	US
Telephone Number	:	786-390-6396
Fax Number	:

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

Provider Enumeration Date	:	06/26/2026
Last Update Date	:	06/26/2026

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