MEDICARE: MISS CONCETTA ANGELA EMMANUELE MSPT

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	22930	FL

General Provider Information

NPI Number	:	1982783031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CONCETTA ANGELA EMMANUELE MSPT

Provider Business Mailing Address
First Line	:	4800 GULF OF MEXICO DR PH 5
Second Line	:
City	:	LONGBOAT KEY
State	:	FL
Zip	:	34228-2144
Country	:	US
Telephone Number	:	941-383-2953
Fax Number	:

Provider Business Practice Location Address
First Line	:	6404 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-2605
Country	:	US
Telephone Number	:	941-782-0201
Fax Number	:	941-795-7268

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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Directions to “ MISS CONCETTA ANGELA EMMANUELE MSPT” Practice Location

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