MEDICARE: MRS. BELINDA JUNE WALTERS P.T.

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	PT0003874	FL

General Provider Information

NPI Number	:	1679856793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BELINDA JUNE WALTERS P.T.

Provider Business Mailing Address
First Line	:	16434 SW 67TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33331-4613
Country	:	US
Telephone Number	:	954-434-6783
Fax Number	:

Provider Business Practice Location Address
First Line	:	16434 SW 67TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33331-4613
Country	:	US
Telephone Number	:	954-434-6783
Fax Number	:

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

Provider Enumeration Date	:	09/25/2011
Last Update Date	:	09/25/2011

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