MEDICARE: HEALTHSPOT PHYSICAL THERAPY & FITNESS, 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	225100000X	Physical Therapist	PT018683	FL

General Provider Information

NPI Number	:	1780891424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHSPOT PHYSICAL THERAPY & FITNESS, INC

Provider Business Mailing Address
First Line	:	1510 ROYAL PALM SQUARE BLVD
Second Line	:	SUITE 105
City	:	FORT MYERS
State	:	FL
Zip	:	33919-1068
Country	:	US
Telephone Number	:	239-274-7008
Fax Number	:	239-274-7070

Provider Business Practice Location Address
First Line	:	1510 ROYAL PALM SQUARE BLVD
Second Line	:	SUITE 105
City	:	FORT MYERS
State	:	FL
Zip	:	33919-1068
Country	:	US
Telephone Number	:	239-274-7008
Fax Number	:	239-274-7070

Authorized Official
Title or Position	:	OWNER
Name	:	AMY MCBREEN BABB
Credential	:	DPT
Telephone Number	:	239-274-7008

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	08/22/2020

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