MEDICARE: M & M THERAPY SERVICES LLC

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	225100000X	Physical Therapist	PT22811	FL

General Provider Information

NPI Number	:	1124191135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M & M THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	12334 COUNTRY DAY CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-7626
Country	:	US
Telephone Number	:	239-738-0897
Fax Number	:	239-481-2381

Provider Business Practice Location Address
First Line	:	12334 COUNTRY DAY CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-7626
Country	:	US
Telephone Number	:	239-738-0897
Fax Number	:	239-481-2381

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MRS. MARIA VICTORIA GINSBURG
Credential	:	P.T.
Telephone Number	:	239-738-0897

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	08/22/2020

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