MEDICARE: RICKI SUE HANZEL PT, DPT, MSPT, COMT

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2939	OTHER	HI	HAWAII PT LICENSE
2	20752	OTHER	FL	LICENSE #

General Provider Information

NPI Number	:	1699882381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICKI SUE HANZEL PT, DPT, MSPT, COMT

Provider Business Mailing Address
First Line	:	2721 OCEAN CLUB BLVD
Second Line	:	APT. 106
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-3945
Country	:	US
Telephone Number	:	954-804-8305
Fax Number	:	754-400-8912

Provider Business Practice Location Address
First Line	:	2721 OCEAN CLUB BLVD
Second Line	:	106
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-3945
Country	:	US
Telephone Number	:	954-804-8305
Fax Number	:	754-400-8912

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	02/23/2017

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Directions to “ RICKI SUE HANZEL PT, DPT, MSPT, COMT” Practice Location

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