MEDICARE: CHRISTIE BOTT 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1205611571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIE BOTT DPT

Provider Business Mailing Address
First Line	:	4989 W BREEZE CIR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1126
Country	:	US
Telephone Number	:	516-455-7200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 E LAKE RD STE 101
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-2411
Country	:	US
Telephone Number	:	727-781-1223
Fax Number	:

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

Provider Enumeration Date	:	08/25/2023
Last Update Date	:	08/25/2023

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Directions to “ CHRISTIE BOTT DPT” Practice Location

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