MEDICARE: PHYSIOWORKS 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	225X00000X	Occupational Therapist	OT3289	FL
2	225100000X	Physical Therapist	PT4313	FL

General Provider Information

NPI Number	:	1700940020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOWORKS INC

Provider Business Mailing Address
First Line	:	1279 N SUMTER BLVD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-8021
Country	:	US
Telephone Number	:	941-240-8602
Fax Number	:	941-240-8607

Provider Business Practice Location Address
First Line	:	1279 N SUMTER BLVD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-8021
Country	:	US
Telephone Number	:	941-240-8602
Fax Number	:	941-240-8607

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD BARLETTA
Credential	:	MPH, PT
Telephone Number	:	941-497-1737

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	02/20/2008

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Directions to “PHYSIOWORKS INC ” Practice Location

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