MEDICARE: LISA LOREN AMORUSO PT

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 25378	FL

General Provider Information

NPI Number	:	1518206069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA LOREN AMORUSO PT

Provider Business Mailing Address
First Line	:	8313 CREEDMOOR LN
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-4599
Country	:	US
Telephone Number	:	727-857-6261
Fax Number	:

Provider Business Practice Location Address
First Line	:	8313 CREEDMOOR LN
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-4599
Country	:	US
Telephone Number	:	727-857-6261
Fax Number	:

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

Provider Enumeration Date	:	02/04/2013
Last Update Date	:	02/04/2013

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