MEDICARE: MRS. BENI DIAS NEVES BORGES 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	PT 15753	FL

General Provider Information

NPI Number	:	1598707275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BENI DIAS NEVES BORGES P.T.

Provider Business Mailing Address
First Line	:	8083 TORTUGA LN
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-1739
Country	:	US
Telephone Number	:	561-736-9104
Fax Number	:	561-736-9104

Provider Business Practice Location Address
First Line	:	1620 S CONGRESS AVE
Second Line	:	STE 201
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2128
Country	:	US
Telephone Number	:	561-439-1800
Fax Number	:	561-439-4874

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

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	07/08/2007

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