MEDICARE: RYAN BURKE DPT

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	PTT32648	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164952552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN BURKE DPT

Provider Business Mailing Address
First Line	:	13837 CIRCA CROSSING DR
Second Line	:
City	:	LITHIA
State	:	FL
Zip	:	33547-4382
Country	:	US
Telephone Number	:	813-684-2663
Fax Number	:	813-658-6222

Provider Business Practice Location Address
First Line	:	10740 PALM RIVER RD STE 310
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4577
Country	:	US
Telephone Number	:	813-684-2663
Fax Number	:

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

Provider Enumeration Date	:	06/18/2017
Last Update Date	:	03/28/2024

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Directions to “ RYAN BURKE DPT” Practice Location

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