MEDICARE: LIMA THERAPY GROUP OF PALM BEACH, 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	2251P0200X	Pediatric Physical Therapist		FL

General Provider Information

NPI Number	:	1639360241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMA THERAPY GROUP OF PALM BEACH, INC

Provider Business Mailing Address
First Line	:	6182 NW 66TH AVE
Second Line	:
City	:	PARKLAND
State	:	FL
Zip	:	33067-1353
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5055 S CONGRESS AVE
Second Line	:	304
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4722
Country	:	US
Telephone Number	:	954-984-2701
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GENY LIMA
Credential	:
Telephone Number	:	954-984-2701

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	08/08/2007

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