PRO VITA PHYSICAL THERAPY LLC (NPI# 1790332351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790332351 |
| Entity Type | Organization |
| Organization Name | PRO VITA PHYSICAL THERAPY LLC |
| Practice Address |
521 E Cedar Ave Crestview FL 32539-2803 |
| Mailing Address |
521 E Cedar Ave Ste A Crestview FL 32539-2803 |
| Practice Telephone | 8509027315 |
| Mailing Telephone | 8503313017 |
| Mailing Fax Number | 8503316635 |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-11-25 |
| Authorized Official Name | CARLA BULLA (OWNER) |
| Authorized Official Telephone | 8509027315 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FLORIDA BLUE | 8JY2N | 01 |
| Street Address |
521 E CEDAR AVE |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32539-2803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326418336 | Abc Pediatrics of Okaloosa | Pediatrics | 182 E. Redstone Ave, Suite B, Crestview, FL 32539 | 2015-10-02 |
| 1336498443 | Jessica Carolina Carroll | Counselor | 259 E. Oakdale Ave, Crestview, FL 32539 | 2012-09-05 |
| 1902167166 | Patricia Guess | Registered Nurse | 6011 Aubrey Lee Ln, Crestview, FL 32539 | 2012-06-05 |
| 1699048181 | Chien Nguyen | Clinical Medical Laboratory | 151 East Redstone Avenue, Crestview, FL 32539 | 2012-02-15 |
| 1043494164 | Crestview Mri | Clinic/Center | 700 Hospital Drive, Crestview, FL 32539 | 2007-12-26 |
| 1558581215 | Barnes Healthcare of Fl LLC | Durable Medical Equipment & Medical Supplies | 450 Brookmeade Dr, Crestview, FL 32539 | 2007-04-26 |
| 1568576098 | Okaloosa Youth Development Center | Substance Abuse Rehabilitation Facility | 4449 Straighline Road, Crestview, FL 32539 | 2006-08-19 |
| 1154368181 | Marcello Borzatta | Surgery | 129 E. Redstone Ave, Suite A, Crestview, FL 32539 | 2006-05-31 |
| 1902850258 | Panhandle Orthopaedics LLC | Physical Therapist | 710 Hospital Drive, Crestview, FL 32539 | 2006-05-20 |
| 1619941440 | Yale R Smith | Anesthesiology | 151 Redstone Ave Se, Pinnacle Physicians LLC, Crestview, FL 32539 | 2006-02-16 |
| Find all providers in zip 32539 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700823044 | Orthopedic & Sports Physical Therapy Center LLC | Clinic/Center | 610 Hospital Dr, Crestview, FL 32539-7356 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942742 | Restore Pelvic Health & Rehab LLC | Clinic/Center | 301 E Yamato Rd Ste 1240, Boca Raton, FL 33431-4931 | 2020-11-03 |
| 1558962019 | Ldg Medical Center LLC | Clinic/Center | 4485 Stirling Rd, Davie, FL 33314-7517 | 2020-11-02 |
| 1255930855 | Tideline Sports Performance & Rehabilitation LLC | Clinic/Center | 5261 Paylor Ln, Lakewood Ranch, FL 34240-2203 | 2020-10-23 |
| 1578162780 | Fourth Trimester Wellness LLC | Clinic/Center | 711 Chancellar Dr, Lutz, FL 33548-4512 | 2020-10-19 |
| 1306445754 | Concierge Rehab Inc | Clinic/Center | 1045 E Heritage Club Cir, Delray Beach, FL 33483-3483 | 2020-10-17 |
| 1689272627 | Ucdm Services Inc | Clinic/Center | 12030 Sw 129th Ct Ste 103, Miami, FL 33186-4584 | 2020-10-12 |
| 1902404163 | Frontline Physical Therapy | Clinic/Center | 8655 Bayou Way N, Pinellas Park, FL 33782-4549 | 2020-10-11 |
| 1891393138 | Venice Physical Therapy and Sports Medicine | Clinic/Center | 1776 S Tamiami Trl, Venice, FL 34293-1602 | 2020-10-09 |
| 1750988812 | Angeles Medical Center,inc. | Clinic/Center | 8725 Nw 18th Ter Ste 403, Doral, FL 33172-2610 | 2020-10-02 |
| 1740887967 | Neuro Thrive LLC | Clinic/Center | 1963 Ne Felicita Pl, Jensen Beach, FL 34957-5756 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
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| 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.