MEDICARE: PHILIP J BLATT PT

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	PT29551	FL

General Provider Information

NPI Number	:	1245533900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP J BLATT PT

Provider Business Mailing Address
First Line	:	2200 VIA ROYALE APT 2201
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-6988
Country	:	US
Telephone Number	:	561-316-6225
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 JUPITER LAKES BLVD STE 4201
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-7190
Country	:	US
Telephone Number	:	561-745-0028
Fax Number	:	561-745-0833

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

Provider Enumeration Date	:	12/17/2010
Last Update Date	:	08/07/2020

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Directions to “ PHILIP J BLATT PT” Practice Location

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