MEDICARE: PALM BEACH PHYSICAL THERAPY

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	Y914L	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1861542102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM BEACH PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	6313 S. DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405
Country	:	US
Telephone Number	:	561-434-2207
Fax Number	:

Provider Business Practice Location Address
First Line	:	6313 S. DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405
Country	:	US
Telephone Number	:	561-434-2207
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	FAYZIURI COBO
Credential	:
Telephone Number	:	561-434-2207

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	08/22/2020

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Directions to “PALM BEACH PHYSICAL THERAPY ” Practice Location

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