MEDICARE: ACCEL THERAPEUTICS 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	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	65-0-H2-2478-0	OTHER	MI	BCBS PIN

General Provider Information

NPI Number	:	1811039860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCEL THERAPEUTICS INC

Provider Business Mailing Address
First Line	:	10766 BERRY CREEK RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-5008
Country	:	US
Telephone Number	:	734-239-5724
Fax Number	:	215-975-5535

Provider Business Practice Location Address
First Line	:	10766 BERRY CREEK RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-5008
Country	:	US
Telephone Number	:	734-239-5724
Fax Number	:	215-975-5535

Authorized Official
Title or Position	:	OWNER
Name	:	JIGAR VYAS
Credential	:
Telephone Number	:	734-239-5724

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/06/2020

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