MEDICARE: LINDA HOLLY NASH PT

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	PT 2545	FL

General Provider Information

NPI Number	:	1386789600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA HOLLY NASH PT

Provider Business Mailing Address
First Line	:	1102 SW 156TH TER
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33027-2232
Country	:	US
Telephone Number	:	954-704-2371
Fax Number	:

Provider Business Practice Location Address
First Line	:	17670 NW 78TH AVE
Second Line	:	SUITE 113
City	:	HIALEAH
State	:	FL
Zip	:	33015-3664
Country	:	US
Telephone Number	:	305-512-5757
Fax Number	:	305-512-5755

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	09/21/2007

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Directions to “ LINDA HOLLY NASH PT” Practice Location

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