MEDICARE: ANC PHYSICAL THERAPY 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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1518939412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANC PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	4615 NW 72ND AVE
Second Line	:	STE 115
City	:	MIAMI
State	:	FL
Zip	:	33166-5689
Country	:	US
Telephone Number	:	305-591-3284
Fax Number	:	305-594-3093

Provider Business Practice Location Address
First Line	:	4615 NW 72ND AVE
Second Line	:	STE 115
City	:	MIAMI
State	:	FL
Zip	:	33166-5689
Country	:	US
Telephone Number	:	305-591-3284
Fax Number	:	305-594-3093

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. CARIDAD VELAZQUEZ
Credential	:
Telephone Number	:	305-591-3284

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	10/04/2007

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Directions to “ANC PHYSICAL THERAPY INC ” Practice Location

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