MEDICARE: EARL CHENG TAM HEE RPT

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	2251X0800X	Orthopedic Physical Therapist	PT10685	FL

General Provider Information

NPI Number	:	1417589821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EARL CHENG TAM HEE RPT

Provider Business Mailing Address
First Line	:	3854 ENCHANTED OAKS LN
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33875-4781
Country	:	US
Telephone Number	:	863-202-0662
Fax Number	:

Provider Business Practice Location Address
First Line	:	6325 US HIGHWAY 27 N
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-8226
Country	:	US
Telephone Number	:	863-471-2122
Fax Number	:

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

Provider Enumeration Date	:	02/04/2020
Last Update Date	:	02/04/2020

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