MEDICARE: DANIEL PEDRO VERGARA

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

General Provider Information

NPI Number	:	1518519792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL PEDRO VERGARA

Provider Business Mailing Address
First Line	:	PO BOX 162743
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32716-2743
Country	:	US
Telephone Number	:	954-580-4080
Fax Number	:	954-530-5096

Provider Business Practice Location Address
First Line	:	4800 NE 20TH TER STE 303
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4510
Country	:	US
Telephone Number	:	954-771-8177
Fax Number	:	954-771-3629

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

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	05/11/2026

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Directions to “ DANIEL PEDRO VERGARA ” Practice Location

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