MEDICARE: MS. BRITTANY ANN VALENTINE PTA

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	225200000X	Physical Therapy Assistant	27842	FL

General Provider Information

NPI Number	:	1750809596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRITTANY ANN VALENTINE PTA

Provider Business Mailing Address
First Line	:	10294 158TH ST N
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33478-9337
Country	:	US
Telephone Number	:	561-779-1693
Fax Number	:

Provider Business Practice Location Address
First Line	:	4362 NORTHLAKE BLVD STE 105
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6270
Country	:	US
Telephone Number	:	561-625-6860
Fax Number	:	561-625-6859

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

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	08/31/2017

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