MEDICARE: PALM BEACH PEDIATRIC THERAPY, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QH0700X	Hearing and Speech Clinic/Center
2	261QP2000X	Physical Therapy Clinic/Center
3	261QX0100X	Occupational Medicine Clinic/Center

General Provider Information

NPI Number	:	1487095626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM BEACH PEDIATRIC THERAPY, INC

Provider Business Mailing Address
First Line	:	1207 OAKWATER DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-6107
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1207 OAKWATER DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-6107
Country	:	US
Telephone Number	:	561-414-3143
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SEJAL PATEL
Credential	:
Telephone Number	:	561-414-3143

Provider Enumeration Date	:	07/16/2013
Last Update Date	:	07/16/2013

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