MEDICARE: MRS. MEGHAN ELIZABETH BURBACH P.T.

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	PT26671	FL

General Provider Information

NPI Number	:	1851700207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGHAN ELIZABETH BURBACH P.T.

Provider Business Mailing Address
First Line	:	12220 TOWNE LAKE DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8013
Country	:	US
Telephone Number	:	239-433-6700
Fax Number	:	239-433-6706

Provider Business Practice Location Address
First Line	:	12220 TOWNE LAKE DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8013
Country	:	US
Telephone Number	:	239-433-6700
Fax Number	:	239-433-6706

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

Provider Enumeration Date	:	08/11/2014
Last Update Date	:	04/08/2026

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