MEDICARE: BETH CAMMARANO THOMPSON DPT

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	PT016599	PA
2	225100000X	Physical Therapist	PT35705	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588854939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH CAMMARANO THOMPSON DPT

Provider Business Mailing Address
First Line	:	11686 FICTION AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-5092
Country	:	US
Telephone Number	:	610-207-7940
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 E LAKE MARY BLVD STE 113
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32773-7111
Country	:	US
Telephone Number	:	407-203-9492
Fax Number	:

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

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	06/26/2023

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