MEDICARE: TRIUMPH KIDS, 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	PT22150	FL

General Provider Information

NPI Number	:	1164954970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIUMPH KIDS, INC

Provider Business Mailing Address
First Line	:	9840 ALTERNATE A1A
Second Line	:	SUITE 402
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4934
Country	:	US
Telephone Number	:	561-906-8674
Fax Number	:

Provider Business Practice Location Address
First Line	:	9840 ALTERNATE A1A
Second Line	:	SUITE 402
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4934
Country	:	US
Telephone Number	:	561-906-8674
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRISTINE MAALE
Credential	:	DPT
Telephone Number	:	561-906-8674

Provider Enumeration Date	:	03/30/2017
Last Update Date	:	03/30/2017

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Directions to “TRIUMPH KIDS, INC ” Practice Location

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