MEDICARE: BEAL PHYSICAL THERAPY P L

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	PT 4764	FL

General Provider Information

NPI Number	:	1508976176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAL PHYSICAL THERAPY P L

Provider Business Mailing Address
First Line	:	500 NORTHPOINT PKWY STE 200
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-1903
Country	:	US
Telephone Number	:	561-688-1844
Fax Number	:	561-688-1845

Provider Business Practice Location Address
First Line	:	500 NORTHPOINT PKWY STE 200
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-1903
Country	:	US
Telephone Number	:	561-688-1844
Fax Number	:	561-688-1845

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER GWEN BEAL
Credential	:	DPT
Telephone Number	:	561-688-1844

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/17/2018

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