MEDICARE: DR. MICHAEL MANN PT, DPT

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	34421	FL

General Provider Information

NPI Number	:	1972166122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL MANN PT, DPT

Provider Business Mailing Address
First Line	:	3495 SW ASPEN PL
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-1836
Country	:	US
Telephone Number	:	772-214-4402
Fax Number	:	772-230-4982

Provider Business Practice Location Address
First Line	:	3495 SW ASPEN PL
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-1836
Country	:	US
Telephone Number	:	772-214-4402
Fax Number	:	772-230-4982

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

Provider Enumeration Date	:	04/15/2019
Last Update Date	:	03/09/2022

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