MEDICARE: ACTION PHYSICAL THERAPY, LLC

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

General Provider Information

NPI Number	:	1912449091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTION PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	4971 LE CHALET BLVD
Second Line	:	100
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-1418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 N FEDERAL HWY
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3200
Country	:	US
Telephone Number	:	954-781-8011
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN PAPA
Credential	:
Telephone Number	:	561-801-2535

Provider Enumeration Date	:	11/07/2016
Last Update Date	:	12/12/2016

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Directions to “ACTION PHYSICAL THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

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