MEDICARE: SUNCOAST PHYSICAL TRAINING & REHABILITATION CENTER 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	261QP2000X	Physical Therapy Clinic/Center	PT5624	FL

General Provider Information

NPI Number	:	1902863392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNCOAST PHYSICAL TRAINING & REHABILITATION CENTER INC

Provider Business Mailing Address
First Line	:	PO BOX 6813
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33758-6813
Country	:	US
Telephone Number	:	727-571-3222
Fax Number	:	727-573-0332

Provider Business Practice Location Address
First Line	:	10863 PARK BLVD STE 4
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-5423
Country	:	US
Telephone Number	:	727-571-3222
Fax Number	:	727-573-0332

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. TRISH JONES
Credential	:
Telephone Number	:	727-571-3222

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	09/27/2013

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