MEDICARE: MRS. MIRANDA JANE ANZIANO PT, DPT

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	2251X0800X	Orthopedic Physical Therapist	PT27493	FL

General Provider Information

NPI Number	:	1700361425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MIRANDA JANE ANZIANO PT, DPT

Provider Business Mailing Address
First Line	:	8000 SR 64 E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34212
Country	:	US
Telephone Number	:	941-792-1404
Fax Number	:	941-761-0712

Provider Business Practice Location Address
First Line	:	6202 17TH AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-7838
Country	:	US
Telephone Number	:	941-792-1404
Fax Number	:	941-761-0712

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

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	05/26/2022

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