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NPI Code Detail

MEDICARE: JOHN MCDONALD PTA

MEDICARE: JOHN MCDONALD PTA
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
1225200000XPhysical Therapy AssistantPTA19624FL

General Provider Information

NPI Number : 1376375766
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MCDONALD PTA
Provider Business Mailing Address
First Line : 9528 TRUMPET VINE LOOP
Second Line :
City : TRINITY
State : FL
Zip : 34655-5374
Country : US
Telephone Number : 239-289-7434
Fax Number :
Provider Business Practice Location Address
First Line : 2960 TAMPA RD
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-3340
Country : US
Telephone Number : 727-939-6448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2024
Last Update Date : 08/15/2024

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