MEDICARE: MR. MICHAEL A BOSMAN P.T. , C.O.M.T.

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 00010998	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316086168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL A BOSMAN P.T. , C.O.M.T.

Provider Business Mailing Address
First Line	:	2485 JOHNNA CT
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-2032
Country	:	US
Telephone Number	:	727-787-6179
Fax Number	:

Provider Business Practice Location Address
First Line	:	5311 GRAND BLVD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4014
Country	:	US
Telephone Number	:	727-848-3962
Fax Number	:	727-848-7028

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	07/30/2024

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