MEDICARE: JOSE MANZO PT, DPT

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	PT36575	FL
2	2251X0800X	Orthopedic Physical Therapist	PT36575	FL

General Provider Information

NPI Number	:	1518559269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE MANZO PT, DPT

Provider Business Mailing Address
First Line	:	10155 DOWDEN RD STE 302
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-5227
Country	:	US
Telephone Number	:	407-569-1700
Fax Number	:	407-569-1701

Provider Business Practice Location Address
First Line	:	10155 DOWDEN RD STE 302
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-5227
Country	:	US
Telephone Number	:	407-569-1700
Fax Number	:	407-569-1701

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

Provider Enumeration Date	:	02/04/2021
Last Update Date	:	07/23/2024

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Directions to “ JOSE MANZO PT, DPT” Practice Location

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