MEDICARE: ADVANCED PHYSICAL MEDICINE INC

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1790232866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PHYSICAL MEDICINE INC

Provider Business Mailing Address
First Line	:	12554 S JOHN YOUNG PKWY
Second Line	:	SUITE 103
City	:	ORLANDO
State	:	FL
Zip	:	32837-4004
Country	:	US
Telephone Number	:	407-282-3615
Fax Number	:	407-275-7221

Provider Business Practice Location Address
First Line	:	12554 S JOHN YOUNG PKWY
Second Line	:	SUITE 103
City	:	ORLANDO
State	:	FL
Zip	:	32837-4004
Country	:	US
Telephone Number	:	407-282-3615
Fax Number	:	407-275-7221

Authorized Official
Title or Position	:	OWNER
Name	:	ESTHER PICHARDO
Credential	:	D.C.
Telephone Number	:	407-282-3615

Provider Enumeration Date	:	09/07/2016
Last Update Date	:	09/07/2016

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Directions to “ADVANCED PHYSICAL MEDICINE INC ” Practice Location

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