MEDICARE: DR. LAUREN JEAN GIARDINO 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 28094	FL

General Provider Information

NPI Number	:	1316287626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN JEAN GIARDINO DPT

Provider Business Mailing Address
First Line	:	1680 SW SAINT LUCIE WEST BLVD
Second Line	:	202
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-1927
Country	:	US
Telephone Number	:	772-878-3322
Fax Number	:	772-878-5030

Provider Business Practice Location Address
First Line	:	1680 SW SAINT LUCIE WEST BLVD
Second Line	:	202
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-1927
Country	:	US
Telephone Number	:	772-878-3322
Fax Number	:	772-878-5030

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

Provider Enumeration Date	:	02/22/2013
Last Update Date	:	02/22/2013

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