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NPI Code Detail

MEDICARE: MRS. ANTONINA BRICHOK P.T.

MEDICARE:  MRS. ANTONINA  BRICHOK  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
1225100000XPhysical Therapist16602FL

General Provider Information

NPI Number : 1578532180
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANTONINA BRICHOK P.T.
Provider Business Mailing Address
First Line : 301 174TH ST
Second Line : 1903
City : SUNNY ISLES BEACH
State : FL
Zip : 33160-3206
Country : US
Telephone Number : 305-705-9366
Fax Number : 305-705-9366
Provider Business Practice Location Address
First Line : 301 174TH ST
Second Line : 1903
City : SUNNY ISLES BEACH
State : FL
Zip : 33160-3206
Country : US
Telephone Number : 305-915-7375
Fax Number : 305-705-9366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. ANTONINA BRICHOK P.T.” Practice Location

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