MEDICARE: MR. ALAN LEE MULCAHY PT

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	PT3285	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT3285	OTHER	FL	PT LICENSE

General Provider Information

NPI Number	:	1730298662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALAN LEE MULCAHY PT

Provider Business Mailing Address
First Line	:	11947 SOUTHERN BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-7619
Country	:	US
Telephone Number	:	561-204-2213
Fax Number	:	561-204-2218

Provider Business Practice Location Address
First Line	:	11947 SOUTHERN BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-7619
Country	:	US
Telephone Number	:	561-204-2213
Fax Number	:	561-204-2218

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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