MEDICARE: ON THE MOVE PEDIATRIC PHYSICAL THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	222Q00000X	Developmental Therapist
3	252Y00000X	Early Intervention Provider Agency
4	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1417829946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ON THE MOVE PEDIATRIC PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	4311 PELICAN BLVD
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-7864
Country	:	US
Telephone Number	:	502-523-1741
Fax Number	:

Provider Business Practice Location Address
First Line	:	4311 PELICAN BLVD
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-7864
Country	:	US
Telephone Number	:	502-523-1741
Fax Number	:

Authorized Official
Title or Position	:	PT/OWNER
Name	:	MICHELE MAGNESS
Credential	:	PHYSICAL THERAPIST
Telephone Number	:	502-523-1741

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	12/11/2025

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