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NPI Code Detail

MEDICARE: MRS. REBECCA RATCLIFF PT

MEDICARE: MRS. REBECCA RATCLIFF 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
12251P0200XPediatric Physical TherapistPT001468FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407866254
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA RATCLIFF PT
Provider Business Mailing Address
First Line : PO BOX 998
Second Line :
City : DESTIN
State : FL
Zip : 32540-0998
Country : US
Telephone Number : 850-622-2236
Fax Number : 850-862-2421
Provider Business Practice Location Address
First Line : 4 JACKSON ST NE
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-4925
Country : US
Telephone Number : 850-622-2236
Fax Number : 850-862-2421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 07/08/2007

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