MEDICARE: CHRISTIAN NANNI MSPT

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 20575	FL

General Provider Information

NPI Number	:	1295768208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN NANNI MSPT

Provider Business Mailing Address
First Line	:	11871 SW 9TH CT
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33325-3850
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13163 SW 16TH ST
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33325-5729
Country	:	US
Telephone Number	:	954-588-1453
Fax Number	:	954-474-0777

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	04/17/2014

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Directions to “ CHRISTIAN NANNI MSPT” Practice Location

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