MEDICARE: GUILLERMA FLORENTINO 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	40QA00475700	NJ

General Provider Information

NPI Number	:	1982763975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUILLERMA FLORENTINO PT

Provider Business Mailing Address
First Line	:	150A TICES LN
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-2015
Country	:	US
Telephone Number	:	732-254-5553
Fax Number	:	732-238-6194

Provider Business Practice Location Address
First Line	:	150A TICES LN
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-2015
Country	:	US
Telephone Number	:	732-254-5553
Fax Number	:	732-238-6194

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	05/06/2013

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Directions to “ GUILLERMA FLORENTINO PT” Practice Location

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