MEDICARE: REFINED 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1952090540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFINED PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	620 6TH LN
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3575
Country	:	US
Telephone Number	:	413-977-9395
Fax Number	:

Provider Business Practice Location Address
First Line	:	806 SW FEDERAL HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-2939
Country	:	US
Telephone Number	:	413-977-9395
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIFFANY JESSICA KASA
Credential	:	PT, DPT
Telephone Number	:	772-444-0520

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	04/09/2024

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Directions to “REFINED PHYSICAL THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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