Dr Michael Thomas Rose, DPT, PT | |
463646 State Road 200 Ste 4, Yulee, FL 32097-0303 | |
(904) 261-4414 | |
(904) 261-4614 |
Full Name | Dr Michael Thomas Rose |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 463646 State Road 200 Ste 4, Yulee, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871231019 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT40806 (Florida) | Primary |
Provider Name | Tidewater Physical Therapy Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1457389595 PECOS PAC ID: 6406759281 Enrollment ID: O20041019001029 |
Mailing Address | Practice Location Address |
---|---|
Dr Michael Thomas Rose, DPT, PT Po Box 949, Rome, GA 30162-0949 Ph: (904) 261-4414 | Dr Michael Thomas Rose, DPT, PT 463646 State Road 200 Ste 4, Yulee, FL 32097-0303 Ph: (904) 261-4414 |
Jessica Hope Walczak, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 251 Breezeway St Unit 100, Yulee, FL 32097 Phone: 904-427-8300 | |
Dr. Alexis Nicole Myers, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 463155 Sr 200, Unit 12, Yulee, FL 32097 Phone: 904-849-1625 | |
Jaden Nicole Anderson, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 463155 Sr 200, Unit 12, Yulee, FL 32097 Phone: 904-849-1625 | |
Morgan Riley Beck, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 463155 State Road 200 Ste 12, Yulee, FL 32097 Phone: 904-849-1625 | |
Gabriella Lockwood, Physical Therapist Medicare: Medicare Enrolled Practice Location: 463646 State Road 200 Ste 4, Yulee, FL 32097 Phone: 904-261-4414 Fax: 904-261-4614 | |
Nathan You, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 463646 State Road 200 Ste 4, Yulee, FL 32097 Phone: 904-261-4414 Fax: 904-261-4614 | |
Minhanh Trinh Pham, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 463646 State Road 200 Ste 4, Yulee, FL 32097 Phone: 904-261-4414 Fax: 904-261-4614 |