MEDICARE: MISS DANIELA MALSBURY

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	225200000X	Physical Therapy Assistant	PTA11673	FL

General Provider Information

NPI Number	:	1932412483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DANIELA MALSBURY

Provider Business Mailing Address
First Line	:	6343 VIA DE SONRISA DEL SUR
Second Line	:	STRATFORD COURT AT BOCA POINTE
City	:	BOCA RATON
State	:	FL
Zip	:	33433-8211
Country	:	US
Telephone Number	:	954-632-7371
Fax Number	:

Provider Business Practice Location Address
First Line	:	5064 NE 19 AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5712
Country	:	US
Telephone Number	:	954-632-7371
Fax Number	:

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

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	08/02/2010

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