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NPI Code Detail

MEDICARE: SELES POWELL PT

MEDICARE: SELES POWELL PT
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
1225100000XPhysical TherapistPT43995FL

General Provider Information

NPI Number : 1811857899
Entity Type Code : Individual
Provider Name (Legal Business Name) : SELES POWELL PT
Provider Business Mailing Address
First Line : 11375 BIG BEND RD
Second Line :
City : RIVERVIEW
State : FL
Zip : 33579-7183
Country : US
Telephone Number : 813-805-8167
Fax Number : 844-214-1382
Provider Business Practice Location Address
First Line : 11375 BIG BEND RD
Second Line :
City : RIVERVIEW
State : FL
Zip : 33579-7183
Country : US
Telephone Number : 813-805-8167
Fax Number : 844-214-1382
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2025
Last Update Date : 03/02/2026

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