MEDICARE: FORT LAUDERDALE PHYSICAL THERAPY, 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	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1174862973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT LAUDERDALE PHYSICAL THERAPY, INC.

Provider Business Mailing Address
First Line	:	4800 N FEDERAL HWY
Second Line	:	SUTE 203
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4606
Country	:	US
Telephone Number	:	954-202-9009
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 N FEDERAL HWY
Second Line	:	SUTE 203
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4606
Country	:	US
Telephone Number	:	954-202-9009
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL S GOODKIN
Credential	:	DC
Telephone Number	:	954-202-9009

Provider Enumeration Date	:	02/14/2013
Last Update Date	:	02/14/2013

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