MEDICARE: MR. MARCO ANTONIO DE FRANCHI SIQUEIRA 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
1	225100000X	Physical Therapist	PT2217	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	:	1699817288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARCO ANTONIO DE FRANCHI SIQUEIRA PT

Provider Business Mailing Address
First Line	:	17100 COLLINS AVE
Second Line	:	SUITE 211
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-3675
Country	:	US
Telephone Number	:	305-947-7788
Fax Number	:	305-947-5458

Provider Business Practice Location Address
First Line	:	17100 COLLINS AVE
Second Line	:	SUITE 211
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-3675
Country	:	US
Telephone Number	:	305-947-7788
Fax Number	:	305-947-5458

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

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	10/06/2011

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