MEDICARE: JUSTINE HAROON D.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	PTT27476	FL

General Provider Information

NPI Number	:	1770838831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTINE HAROON D.P.T

Provider Business Mailing Address
First Line	:	2840 E OAKLAND PARK BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1814
Country	:	US
Telephone Number	:	954-565-0075
Fax Number	:

Provider Business Practice Location Address
First Line	:	2840 E OAKLAND PARK BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1814
Country	:	US
Telephone Number	:	954-565-0075
Fax Number	:

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

Provider Enumeration Date	:	07/16/2012
Last Update Date	:	07/16/2012

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