MEDICARE: PHYSIOTHERAPY ASSOCIATES INC

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	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G89	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1003820978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOTHERAPY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	3820 NORTHDALE BLVD STE 101A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1834
Country	:	US
Telephone Number	:	813-264-7734
Fax Number	:

Provider Business Practice Location Address
First Line	:	7274 55TH AVE E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34203-8002
Country	:	US
Telephone Number	:	941-752-4451
Fax Number	:

Authorized Official
Title or Position	:	SR. GROUP BUSINESS MANAGER
Name	:	MELISSA PHILBECK
Credential	:
Telephone Number	:	813-264-7734

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	09/24/2007

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Directions to “PHYSIOTHERAPY ASSOCIATES INC ” Practice Location

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