MEDICARE: JOY SHIRLEY LANDIS 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	261QP2000X	Physical Therapy Clinic/Center	PT24291	FL

General Provider Information

NPI Number	:	1518840727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY SHIRLEY LANDIS PT

Provider Business Mailing Address
First Line	:	2202 SE 20TH PL
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-3107
Country	:	US
Telephone Number	:	260-417-1246
Fax Number	:

Provider Business Practice Location Address
First Line	:	1333 SANTA BARBARA BLVD
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-2803
Country	:	US
Telephone Number	:	239-772-1333
Fax Number	:

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

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	07/28/2025

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