MEDICARE: SPECTRACARE INC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1508934225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRACARE INC

Provider Business Mailing Address
First Line	:	4750 N FEDERAL HWY
Second Line	:	SUITE 100
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4609
Country	:	US
Telephone Number	:	954-772-5431
Fax Number	:	954-771-5722

Provider Business Practice Location Address
First Line	:	4750 N FEDERAL HWY
Second Line	:	SUITE 100
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4609
Country	:	US
Telephone Number	:	954-772-5431
Fax Number	:	954-771-5722

Authorized Official
Title or Position	:	ADMIN
Name	:	MRS. MAGDA SEDRA
Credential	:
Telephone Number	:	954-772-5431

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	10/01/2012

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Directions to “SPECTRACARE INC ” Practice Location

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