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NPI Code Detail

MEDICARE: MATTHEW HIXON PT

MEDICARE: MATTHEW HIXON PT
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
12251X0800XOrthopedic Physical TherapistPT34645FL

General Provider Information

NPI Number : 1093132623
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW HIXON PT
Provider Business Mailing Address
First Line : 5151 WINTER GARDEN VINELAND RD
Second Line :
City : WINDERMERE
State : FL
Zip : 34786-6098
Country : US
Telephone Number : 407-573-3360
Fax Number : 407-643-2811
Provider Business Practice Location Address
First Line : 13944 EUCLID AVE
Second Line :
City : EAST CLEVELAND
State : OH
Zip : 44112-3804
Country : US
Telephone Number : 216-767-4202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2014
Last Update Date : 11/09/2021

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