MEDICARE: MR. JEFFERY PAUL ARGONZA PATAJO 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	PT.012113	OH

General Provider Information

NPI Number	:	1932375011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFERY PAUL ARGONZA PATAJO P.T.

Provider Business Mailing Address
First Line	:	1752 N LANDFAIR ST
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92806-1108
Country	:	US
Telephone Number	:	714-272-8396
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 W COMMERCIAL BLVD
Second Line	:	STE 116
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-3440
Country	:	US
Telephone Number	:	800-886-8108
Fax Number	:

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

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	05/07/2008

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