MEDICARE: NADIA MENDOLIA 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	PT10462	FL

General Provider Information

NPI Number	:	1467485094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA MENDOLIA P.T.

Provider Business Mailing Address
First Line	:	431 35TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-4829
Country	:	US
Telephone Number	:	561-842-8193
Fax Number	:	561-842-8193

Provider Business Practice Location Address
First Line	:	431 35TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-4829
Country	:	US
Telephone Number	:	561-842-8193
Fax Number	:	561-842-8193

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

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	07/08/2007

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