MEDICARE: ZACHARY ENGEL 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	PT.10545	SC
2	225100000X	Physical Therapist	PT36612	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	:	1275123986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY ENGEL DPT

Provider Business Mailing Address
First Line	:	7990 BAYMEADOWS RD E UNIT 1022
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-2979
Country	:	US
Telephone Number	:	615-594-3054
Fax Number	:

Provider Business Practice Location Address
First Line	:	465 TOWN PLAZA AVE # B
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32081-5164
Country	:	US
Telephone Number	:	904-222-3780
Fax Number	:

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

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	03/01/2022

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Directions to “ ZACHARY ENGEL DPT” Practice Location

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