MEDICARE: VIRGINIA SIERRA PHYSICAL THERAPIST, 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	225100000X	Physical Therapist	PT-16757	FL

General Provider Information

NPI Number	:	1134431091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGINIA SIERRA PHYSICAL THERAPIST, INC

Provider Business Mailing Address
First Line	:	2070 HOMEWOOD BLVD
Second Line	:	APT. 202
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-8212
Country	:	US
Telephone Number	:	561-272-0991
Fax Number	:	561-272-0991

Provider Business Practice Location Address
First Line	:	2070 HOMEWOOD BLVD
Second Line	:	APT. 202
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-8212
Country	:	US
Telephone Number	:	561-272-0991
Fax Number	:	561-272-0991

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ONSLEY VIRGINIA SIERRA
Credential	:	R/PT
Telephone Number	:	954-655-4070

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	07/08/2010

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