=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962663427
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AARON SPECTOR PT, DPT, OCS, MTC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2008
-----------------------------------------------------
Last Update Date | 11/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3535 MILITARY TRL SUITE 203
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33458-5009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-744-9191
-----------------------------------------------------
Fax | 561-744-9198
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3535 MILITARY TRL SUITE 203
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33458-5009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-744-9191
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number | PT18942
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------