MEDICARE: MS. RACHEL ANN SECKINGER 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	22535	FL
2	222Q00000X	Developmental Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932211547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RACHEL ANN SECKINGER PT

Provider Business Mailing Address
First Line	:	602 VONDERBURG DR
Second Line	:	SUITE 201
City	:	BRANDON
State	:	FL
Zip	:	33511-5900
Country	:	US
Telephone Number	:	813-653-1149
Fax Number	:	813-654-6644

Provider Business Practice Location Address
First Line	:	602 VONDERBURG DR
Second Line	:	SUITE 201
City	:	BRANDON
State	:	FL
Zip	:	33511-5900
Country	:	US
Telephone Number	:	813-653-1149
Fax Number	:	813-654-6644

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	03/21/2011

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Directions to “ MS. RACHEL ANN SECKINGER PT” Practice Location

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