MEDICARE: ANDREW PARANA PT 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	PT37203	FL
2	225100000X	Physical Therapist	PT028024	PA

General Provider Information

NPI Number	:	1376190017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW PARANA PT DPT

Provider Business Mailing Address
First Line	:	4406 SOUTH FLORIDA AVE
Second Line	:	SUITE 17
City	:	LAKELAND
State	:	FL
Zip	:	33813
Country	:	US
Telephone Number	:	863-646-5088
Fax Number	:	863-904-4701

Provider Business Practice Location Address
First Line	:	4406 SOUTH FLORIDA AVE
Second Line	:	SUITE 17
City	:	LAKELAND
State	:	FL
Zip	:	33813
Country	:	US
Telephone Number	:	863-646-5088
Fax Number	:	863-904-4701

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

Provider Enumeration Date	:	08/19/2019
Last Update Date	:	01/14/2026

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