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NPI Code Detail

MEDICARE: DR. PHYSIO THERAPY & WELLNESS

MEDICARE: DR. PHYSIO THERAPY & WELLNESS
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
1261QP2000XPhysical Therapy Clinic/Center28107FL

General Provider Information

NPI Number : 1154802148
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. PHYSIO THERAPY & WELLNESS
Provider Business Mailing Address
First Line : 4324 N FEDERAL HWY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33308-5208
Country : US
Telephone Number : 954-369-5787
Fax Number : 954-206-7733
Provider Business Practice Location Address
First Line : 4324 N FEDERAL HWY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33308-5208
Country : US
Telephone Number : 954-369-5787
Fax Number : 954-206-7733
Authorized Official
Title or Position : PHYSICAL THERAPIST/OWNER
Name : LENISSON M CARNEIRO
Credential : PT, DPT
Telephone Number : 954-245-4798
Provider Enumeration Date : 08/27/2018
Last Update Date : 06/02/2021

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Directions to “DR. PHYSIO THERAPY & WELLNESS ” Practice Location

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