MEDICARE: JOHN C ARENA 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
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT17917	OTHER	FL	LICENSE#

General Provider Information

NPI Number	:	1841307758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C ARENA PT

Provider Business Mailing Address
First Line	:	1007 N FEDERAL HWY
Second Line	:	#277
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1422
Country	:	US
Telephone Number	:	954-336-7722
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 N FEDERAL HWY
Second Line	:	#277
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1422
Country	:	US
Telephone Number	:	954-336-7722
Fax Number	:

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	11/13/2013

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Directions to “ JOHN C ARENA PT” Practice Location

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