MEDICARE: MODERN THERAPY WORKS INC

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	2251C2600X	Cardiopulmonary Physical Therapist	PT19290	FL
2	2251G0304X	Geriatric Physical Therapist	PT19290	FL
3	225200000X	Physical Therapy Assistant	PTA18578	FL
4	225700000X	Massage Therapist	MA41964	FL
5	225X00000X	Occupational Therapist	OT2608	FL
6	225XE1200X	Ergonomics Occupational Therapist	OT2608	FL
7	225XH1200X	Hand Occupational Therapist	OT2608	FL
8	225XN1300X	Neurorehabilitation Occupational Therapist	OT6562	FL
9	225XP0200X	Pediatric Occupational Therapist	OT6562	FL
10	2278P1005X	Pulmonary Rehabilitation Certified Respiratory Therapist	TT7874	FL
11	235Z00000X	Speech-Language Pathologist	SA3173	FL
12	225100000X	Physical Therapist	PT19290	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Q4J	OTHER	FL	BLUECROSS BLUESHIELD #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659318889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MODERN THERAPY WORKS INC

Provider Business Mailing Address
First Line	:	7036 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-1000
Country	:	US
Telephone Number	:	352-597-1530
Fax Number	:	352-597-0502

Provider Business Practice Location Address
First Line	:	7036 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-1000
Country	:	US
Telephone Number	:	352-597-1530
Fax Number	:	352-597-0502

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	MR. PREM J KUMAR
Credential	:
Telephone Number	:	352-597-1530

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	06/24/2024

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Directions to “MODERN THERAPY WORKS INC ” Practice Location

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