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NPI Code Detail

MEDICARE: MIGUEL LEFORT BSPT

MEDICARE: MIGUEL LEFORT BSPT
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
1225100000XPhysical Therapist5946AZ

General Provider Information

NPI Number : 1982601936
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIGUEL LEFORT BSPT
Provider Business Mailing Address
First Line : 9097 E DESERT COVE AVE
Second Line : SUITE 110
City : SCOTTSDALE
State : AZ
Zip : 85260-6710
Country : US
Telephone Number : 480-860-4298
Fax Number : 480-860-0356
Provider Business Practice Location Address
First Line : 10721 W INDIAN SCHOOL RD
Second Line : SUITE A-101
City : AVONDALE
State : AZ
Zip : 85392-5636
Country : US
Telephone Number : 623-772-7748
Fax Number : 623-772-7749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2005
Last Update Date : 06/12/2013

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