MEDICARE: ADVANCED PHYSICAL THERAPY OF CENTRAL FLORIDA

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

General Provider Information

NPI Number	:	1699211649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PHYSICAL THERAPY OF CENTRAL FLORIDA

Provider Business Mailing Address
First Line	:	1202 SW 17TH ST
Second Line	:	BOX 209-229
City	:	OCALA
State	:	FL
Zip	:	34471-1231
Country	:	US
Telephone Number	:	352-693-3378
Fax Number	:

Provider Business Practice Location Address
First Line	:	2953 TRAVERSE TRL
Second Line	:
City	:	THE VILLAGES
State	:	FL
Zip	:	32163-2017
Country	:	US
Telephone Number	:	352-693-3378
Fax Number	:

Authorized Official
Title or Position	:	PCC TEAM LEADER
Name	:	PHYLLIS RUSSELL
Credential	:
Telephone Number	:	352-693-3378

Provider Enumeration Date	:	01/15/2017
Last Update Date	:	01/15/2017

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