MEDICARE: DR. ADAM ALEXANDER KING 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	PT31185
2	225100000X	Physical Therapist	070022259	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT31185	OTHER	FL	225100000X
2	PT31185	OTHER	FL	PHYSCIAL THERAPY LICENSE

General Provider Information

NPI Number	:	1376097022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM ALEXANDER KING DPT

Provider Business Mailing Address
First Line	:	1336 NE 5TH AVE APT 3
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1047
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1031 SEMINOLE DR
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3243
Country	:	US
Telephone Number	:	954-787-6556
Fax Number	:

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

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	08/04/2023

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