MEDICARE: TERESITA MARIA ANDERSON 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	PT19923	FL

General Provider Information

NPI Number	:	1275661654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESITA MARIA ANDERSON PT

Provider Business Mailing Address
First Line	:	2026 ALTON RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-4563
Country	:	US
Telephone Number	:	305-951-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2026 ALTON RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-4563
Country	:	US
Telephone Number	:	305-951-1100
Fax Number	:

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/08/2007

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