MEDICARE: MR. MICHAEL SEDRA PHYSICAL THERAPIST

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	4299	FL
2	2251E1200X	Ergonomics Physical Therapist	4299	FL
3	2251G0304X	Geriatric Physical Therapist	4299	FL
4	2251N0400X	Neurology Physical Therapist	4299	FL
5	2251S0007X	Sports Physical Therapist	4299	FL
6	2251X0800X	Orthopedic Physical Therapist	4299	FL

General Provider Information

NPI Number	:	1952638181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL SEDRA PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	4750 N FEDERAL HWY
Second Line	:	SUITE# 100
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4609
Country	:	US
Telephone Number	:	954-772-5431
Fax Number	:	954-771-5722

Provider Business Practice Location Address
First Line	:	4750 N FEDERAL HWY
Second Line	:	SUITE# 100
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4609
Country	:	US
Telephone Number	:	954-772-5431
Fax Number	:	954-771-5722

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

Provider Enumeration Date	:	11/09/2009
Last Update Date	:	11/09/2009

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Directions to “ MR. MICHAEL SEDRA PHYSICAL THERAPIST” Practice Location

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