MEDICARE: SEAN MCCUE 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	PT17594	FL

General Provider Information

NPI Number	:	1851504799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEAN MCCUE INC

Provider Business Mailing Address
First Line	:	2357 VINTAGE ST
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-8318
Country	:	US
Telephone Number	:	941-341-0089
Fax Number	:

Provider Business Practice Location Address
First Line	:	10910 E STATE ROAD 70
Second Line	:	SUITE 104
City	:	BRADENTON
State	:	FL
Zip	:	34202-8406
Country	:	US
Telephone Number	:	941-727-2667
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SEAN MICHAEL MCCUE
Credential	:	PT
Telephone Number	:	941-341-0089

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	08/22/2020

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