PHYSICAL THERAPY & SPORTS REHAB LLC (NPI# 1538433552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538433552 |
| Entity Type | Organization |
| Organization Name | PHYSICAL THERAPY & SPORTS REHAB LLC |
| Practice Address |
1290 Old Congress Ave. West Palm Beach FL 33409 |
| Practice Telephone | 5613121120 |
| Practice Fax Number | 9546229120 |
| Mailing Telephone | 5613121120 |
| Mailing Fax Number | 9546229120 |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-08 |
| Authorized Official Name | MR. RICHARD HENRY HOFFMAN (VICE PRESIDENT) |
| Authorized Official Telephone | 5613121120 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
PT21702 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE PTAN | DF544Z | 01 |
| Street Address |
1290 OLD CONGRESS AVE. |
| City | WEST PALM BEACH |
| State | FL |
| Zip Code | 33409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928000 | Gerard Joseph Valerius Jr. | Behavior Technician | 1818 S. Australian Ave, Suite 420, West Palm Beach, FL 33409 | 2020-10-05 |
| 1295342277 | Stela Karkatselos | Nurse Practitioner | 2700 Palm Beach Lakes Blvd., West Palm Beach, FL 33409 | 2020-09-24 |
| 1831703974 | Daylin Gonzalez | Behavior Technician | 1818 S.australian Ave, Suite 420, West Palm Beach, FL 33409 | 2020-09-05 |
| 1518582436 | All-most Family, Inc | In Home Supportive Care | 4047 Okeechobee Blvd., Suite 110, West Palm Beach, FL 33409 | 2020-06-16 |
| 1750911285 | Denisse Ramirez | Technician, Other | 1818 S. Australian Ave, Suite 420, West Palm Beach, FL 33409 | 2020-01-23 |
| 1558915009 | Hess Massage and Fitness LLC. | Massage Therapist | 2090 Palm Beach Lakes Blvd #900, West Palm Beach, FL 33409 | 2019-08-01 |
| 1184195638 | Tyrone Woods | Developmental Therapist | 4287 Lake Lucerne Circle, West Palm Beach, FL 33409 | 2018-12-10 |
| 1700352119 | Julio Cesar Lugo Sr. | Counselor | 4100 Bear Lakes Ct. Building 14, Apt. #108, West Palm Beach, FL 33409 | 2018-10-23 |
| 1073009353 | Kaitlyn Rose Green | Physician Assistant | 560 Village Blvd Suite #150, West Palm Beach, FL 33409 | 2018-07-10 |
| 1063901247 | Dominique J Carn | Technician, Other | 42000 Community Dr, Apt 2211, West Palm Beach, FL 33409 | 2018-05-03 |
| Find all providers in zip 33409 | ||||
| Taxonomy Code | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538721907 | Revolution Sports and Performance LLC | Physical Therapist | 27774 Autumn Breeze Cir, Wesley Chapel, FL 33544-7839 | 2019-07-05 |
| 1790242105 | Ignacio Ray Barajas | Physical Therapist | 11723 Gulf Beach Hwy, Pensacola, FL 32507-9143 | 2019-02-22 |
| 1679041081 | Mauricio Elizondo | Physical Therapist | 201 Atp Tour Blvd, Ponte Vedra Beach, FL 32082-3211 | 2018-11-05 |
| 1194209205 | Jack Malafronte | Physical Therapist | 2221 S Dale Mabry Hwy, Tampa, FL 33629-6313 | 2018-09-25 |
| 1881109791 | Michael R Preciados | Physical Therapist | 2999 Ne 191st St Ste 230, Aventura, FL 33180-3115 | 2017-12-14 |
| 1467970277 | Naples Premier Physical Therapy Inc | Physical Therapist | 3940 Prospect Ave Ste 103, Naples, FL 34104-3745 | 2017-08-31 |
| 1134643356 | Thomas Mulligan | Physical Therapist | 401 Channelside Dr, Tampa, FL 33602-5400 | 2017-07-29 |
| 1962952333 | Jordan Clayborne | Physical Therapist | 4747 N Ocean Dr Ste 261, Lauderdale By The Sea, FL 33308-2956 | 2016-10-10 |
| 1043764483 | Tonny Vandehee | Physical Therapist | 3264 Pacific Dr, Naples, FL 34119-8672 | 2016-08-14 |
| 1861848517 | Physioworks of Miami | Physical Therapist | 3617 E Sandpiper Dr, #5, Boynton Beach, FL 33436-2463 | 2016-05-12 |
| Find all providers with the same taxonomy | ||||
| City | WEST PALM BEACH |
| Zip Code | 33409 |
Please comment or provide details below to improve the information on PHYSICAL THERAPY & SPORTS REHAB LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.