Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Provo

Individual provider Physical Therapist · NPI 1588553259

Justin Provo is a Physical Therapist in Private Practice in Melbourne, Florida. Qualified in 2025, 1 year ago. Practices with Peoples Physical Therapy Inc, an 18-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
1
Licensed in
FL
In the registry since
2025
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Practice location Address checks out

2200 W Eau Gallie Blvd Ste 105
Melbourne, FL 32935-3166
Phone: (255) 255-2818
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT43362 (FL)

Record details

NPI number1588553259
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 30, 2025
Last updated in NPPESAugust 7, 2025
Certification dateAugust 7, 2025
Mailing address2200 W Eau Gallie Blvd Ste 105, Melbourne, FL 32935-3166

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Peoples Physical Therapy Inc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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