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NPI Code Detail

MEDICARE: TINA MARIE PICHARDO PT

MEDICARE:   TINA MARIE PICHARDO  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
1225100000XPhysical Therapist14338FL

General Provider Information

NPI Number : 1568742807
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA MARIE PICHARDO PT
Provider Business Mailing Address
First Line : 910 REGENCY SQ
Second Line :
City : VERO BEACH
State : FL
Zip : 32967-1800
Country : US
Telephone Number : 772-564-9292
Fax Number : 772-564-9293
Provider Business Practice Location Address
First Line : 910 REGENCY SQ
Second Line :
City : VERO BEACH
State : FL
Zip : 32967-1800
Country : US
Telephone Number : 772-564-9292
Fax Number : 772-564-9293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2011
Last Update Date : 08/18/2011

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Directions to “ TINA MARIE PICHARDO PT” Practice Location

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