MEDICARE: EMERSON GARCIA-BECK 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	41595	FL

General Provider Information

NPI Number	:	1336969039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMERSON GARCIA-BECK DPT

Provider Business Mailing Address
First Line	:	5825 SUNSET DR STE 204
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5825 SUNSET DR STE 204
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5222
Country	:	US
Telephone Number	:	813-924-8108
Fax Number	:

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

Provider Enumeration Date	:	10/16/2024
Last Update Date	:	10/16/2024

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