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NPI Code Detail

MEDICARE: JODY RAPPAPORT M PT

MEDICARE:   JODY  RAPPAPORT  M 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
1174400000XSpecialistPT 13771FL

General Provider Information

NPI Number : 1790841542
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODY RAPPAPORT M PT
Provider Business Mailing Address
First Line : 10016 BRIDGETON DR
Second Line :
City : TAMPA
State : FL
Zip : 33626-1840
Country : US
Telephone Number : 813-343-5500
Fax Number : 813-343-5506
Provider Business Practice Location Address
First Line : 12625 RACE TRACK RD
Second Line :
City : TAMPA
State : FL
Zip : 33626-1331
Country : US
Telephone Number : 813-343-5500
Fax Number : 813-343-5506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 07/08/2007

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