MEDICARE: MRS. PATRICIA MARTIN ESTLER PT/ATP

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	222Q00000X	Developmental Therapist	PT3168	FL
2	2251P0200X	Pediatric Physical Therapist	PT 3168	FL
3	225100000X	Physical Therapist	PT 3168	FL

General Provider Information

NPI Number	:	1336349950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA MARTIN ESTLER PT/ATP

Provider Business Mailing Address
First Line	:	9105 VINEYARD LAKE DR
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-1110
Country	:	US
Telephone Number	:	954-778-3348
Fax Number	:

Provider Business Practice Location Address
First Line	:	3840 HULEN ST
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76107-7277
Country	:	US
Telephone Number	:	817-569-4039
Fax Number	:

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

Provider Enumeration Date	:	07/21/2007
Last Update Date	:	08/01/2023

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