MEDICARE: MR. SCOTT ECKARDT P.T.

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	018173-1	NY

General Provider Information

NPI Number	:	1518951169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT ECKARDT P.T.

Provider Business Mailing Address
First Line	:	13020 N TELECOM PARKWAY
Second Line	:
City	:	TEMPLE TERRRACE
State	:	FL
Zip	:	33637-0925
Country	:	US
Telephone Number	:	813-978-9700
Fax Number	:	135-586-1858

Provider Business Practice Location Address
First Line	:	5243 HANFF LANE
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685
Country	:	US
Telephone Number	:	813-978-9700
Fax Number	:	813-558-6185

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	02/15/2024

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