MEDICARE: MRS. MELISSA SCHUBERT P.T.

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	PT16197	FL

General Provider Information

NPI Number	:	1396070710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA SCHUBERT P.T.

Provider Business Mailing Address
First Line	:	1200 LEXINGTON GREEN LN
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32771-1013
Country	:	US
Telephone Number	:	407-688-0070
Fax Number	:

Provider Business Practice Location Address
First Line	:	11543 LAKE UNDERHILL RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-5001
Country	:	US
Telephone Number	:	407-380-0357
Fax Number	:

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

Provider Enumeration Date	:	10/04/2009
Last Update Date	:	02/06/2017

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