MEDICARE: AMY FLAHERTY

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	0700020801	IL
2	225100000X	Physical Therapist	PT40342	FL

General Provider Information

NPI Number	:	1710388566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY FLAHERTY

Provider Business Mailing Address
First Line	:	4211 DUTCHESS PARK RD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-4551
Country	:	US
Telephone Number	:	815-725-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 DUTCHESS PARK RD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-4551
Country	:	US
Telephone Number	:	708-207-8433
Fax Number	:

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

Provider Enumeration Date	:	09/11/2014
Last Update Date	:	05/27/2024

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Directions to “ AMY FLAHERTY ” Practice Location

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