MEDICARE: ELEVATE PHYSICAL THERAPY AND PILATES

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1376306431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATE PHYSICAL THERAPY AND PILATES

Provider Business Mailing Address
First Line	:	1008 WATSON ST
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-3318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1114 WHITE ST
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-3327
Country	:	US
Telephone Number	:	347-968-2458
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICAL THERAPY
Name	:	LAUREN CHANG
Credential	:
Telephone Number	:	347-968-2458

Provider Enumeration Date	:	02/01/2024
Last Update Date	:	02/01/2024

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