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NPI Code Detail

MEDICARE: BAY AREA NEUROMUSCULAR THERAPY LLC

MEDICARE: BAY AREA NEUROMUSCULAR THERAPY 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
1225100000XPhysical TherapistK1146FL
2261Q00000XClinic/Center

General Provider Information

NPI Number : 1154588689
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAY AREA NEUROMUSCULAR THERAPY LLC
Provider Business Mailing Address
First Line : 1478 JORDAN HILLS CT
Second Line :
City : CLEARWATER
State : FL
Zip : 33756-2368
Country : US
Telephone Number : 727-461-3896
Fax Number : 727-443-4085
Provider Business Practice Location Address
First Line : 1478 JORDAN HILLS CT
Second Line :
City : CLEARWATER
State : FL
Zip : 33756-2368
Country : US
Telephone Number : 727-461-3896
Fax Number : 727-443-4085
Authorized Official
Title or Position : DIRECTOR
Name : ROGER L NEAL
Credential :
Telephone Number : 727-461-3896
Provider Enumeration Date : 05/21/2008
Last Update Date : 12/03/2021

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