MEDICARE: PT360HEALTH LLC

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

General Provider Information

NPI Number	:	1457066813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PT360HEALTH LLC

Provider Business Mailing Address
First Line	:	8922 JASPERS DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-2433
Country	:	US
Telephone Number	:	310-739-1843
Fax Number	:

Provider Business Practice Location Address
First Line	:	8922 JASPERS DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-2433
Country	:	US
Telephone Number	:	310-739-1843
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	JAGRUTI RAMESHBHAI HIRANI
Credential	:	PT
Telephone Number	:	310-739-1843

Provider Enumeration Date	:	01/19/2023
Last Update Date	:	01/19/2023

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