MEDICARE: THERAPY PROFESSIONAL NETWORK

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1962360776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY PROFESSIONAL NETWORK

Provider Business Mailing Address
First Line	:	5810 RAINTREE TRL
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-7508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5810 RAINTREE TRL
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-7508
Country	:	US
Telephone Number	:	772-370-7450
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. HAYLEY NEMOGA
Credential	:	PTA
Telephone Number	:	772-485-3446

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “THERAPY PROFESSIONAL NETWORK ” Practice Location

Language	Start Address	Practice Location

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