MEDICARE: JEAN MICHEL TONY RRT

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	227900000X	Registered Respiratory Therapist	RT9638	FL

General Provider Information

NPI Number	:	1073753539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN MICHEL TONY RRT

Provider Business Mailing Address
First Line	:	16245 SW 36TH DR
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4524
Country	:	US
Telephone Number	:	305-494-7660
Fax Number	:

Provider Business Practice Location Address
First Line	:	16245 SW 36TH DR
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4524
Country	:	US
Telephone Number	:	305-494-7660
Fax Number	:

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

Provider Enumeration Date	:	02/24/2009
Last Update Date	:	02/24/2009

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