MEDICARE: MICHAEL SCOTT DEMAHY 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	14903	FL

General Provider Information

NPI Number	:	1538349014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SCOTT DEMAHY PT

Provider Business Mailing Address
First Line	:	1040 GULF BREEZE PKWY STE 101
Second Line	:
City	:	GULF BREEZE
State	:	FL
Zip	:	32561-7808
Country	:	US
Telephone Number	:	850-934-2180
Fax Number	:

Provider Business Practice Location Address
First Line	:	1040 GULF BREEZE PKWY STE 101
Second Line	:
City	:	GULF BREEZE
State	:	FL
Zip	:	32561-7808
Country	:	US
Telephone Number	:	850-934-2180
Fax Number	:

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

Provider Enumeration Date	:	11/13/2007
Last Update Date	:	11/13/2007

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Directions to “ MICHAEL SCOTT DEMAHY PT” Practice Location

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