MEDICARE: DR. SUSAN W VARGHESE DPT

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	PT37033	CA
2	225100000X	Physical Therapist	PT24437	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT24437	OTHER	FL	PHYSICAL THERAPY BOARD OF FLORIDA
2	PT37033	OTHER	CA	PHYSICAL THERAPY BOARD OF CALIFORNIA

General Provider Information

NPI Number	:	1497056584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN W VARGHESE DPT

Provider Business Mailing Address
First Line	:	2021 E COMMERCIAL BLVD STE 308
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3769
Country	:	US
Telephone Number	:	954-323-4484
Fax Number	:

Provider Business Practice Location Address
First Line	:	2021 E COMMERCIAL BLVD STE 308
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3769
Country	:	US
Telephone Number	:	954-323-4484
Fax Number	:

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

Provider Enumeration Date	:	11/05/2010
Last Update Date	:	07/13/2023

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Directions to “ DR. SUSAN W VARGHESE DPT” Practice Location

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