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General NPI Number Information
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NPI Number | 1285549543
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Entity Type | Individual
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Provider Name | MATTHEW WALTER PANZICA PT, DPT
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Gender |
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Dates
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Enumeration Date | 08/18/2026
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Last Update Date | 08/18/2026
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Provider Practice Location Address
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Address Line | 5970 S JOG RD
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City | LAKE WORTH
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State | FL
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Zip | 33467-6590
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Country | US
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Telephone | 561-432-3693
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Fax |
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Provider Business Mailing Address
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Address Line | 222 BLANCA ISLES LN
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City | JUPITER
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State | FL
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Zip | 33478-5477
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Country | US
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Telephone | 732-609-6811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT45161
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License Number State | FL
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