MEDICARE: APEX PHYSICAL THERAPY OF SOUTHWEST FLORIDA, 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	225100000X	Physical Therapist	057304	FL

General Provider Information

NPI Number	:	1821014069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APEX PHYSICAL THERAPY OF SOUTHWEST FLORIDA, INC.

Provider Business Mailing Address
First Line	:	15751 SAN CARLOS BLVD
Second Line	:	SUITE #4
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3314
Country	:	US
Telephone Number	:	239-337-2739
Fax Number	:	239-337-2738

Provider Business Practice Location Address
First Line	:	15751 SAN CARLOS BLVD
Second Line	:	SUITE #4
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3314
Country	:	US
Telephone Number	:	239-337-2739
Fax Number	:	239-337-2738

Authorized Official
Title or Position	:	PRESIDENT / PHYSICAL THERAPIST
Name	:	MRS. ANGELA CAROL MCGILVREY
Credential	:	PT
Telephone Number	:	239-337-2739

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	08/22/2020

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