MEDICARE: MR. ROBERT J MURDOCCO RPT

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 13318	FL

General Provider Information

NPI Number	:	1144385550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT J MURDOCCO RPT

Provider Business Mailing Address
First Line	:	519 W 41ST ST
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3509
Country	:	US
Telephone Number	:	305-672-2992
Fax Number	:	305-672-2913

Provider Business Practice Location Address
First Line	:	519 W 41ST ST
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3509
Country	:	US
Telephone Number	:	305-672-2992
Fax Number	:	305-672-2913

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	08/19/2010

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