1720155997 NPI number — ACUPUNCTURE AND PHYSICAL THERAPY SPECIALISTS, INC.

Table of content: (NPI 1720155997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720155997 NPI number — ACUPUNCTURE AND PHYSICAL THERAPY SPECIALISTS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACUPUNCTURE AND PHYSICAL THERAPY SPECIALISTS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AMERICAN REHAB CONNECTIONS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720155997
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 953925
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE MARY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32795-3925
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
386-774-6333
Provider Business Mailing Address Fax Number:
386-410-1603

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2501 S VOLUSIA AVE STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORANGE CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32763-9134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-774-6333
Provider Business Practice Location Address Fax Number:
386-410-1603
Provider Enumeration Date:
11/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LIN
Authorized Official First Name:
MENN-LI
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL MANAGER
Authorized Official Telephone Number:
386-774-6333

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AP2096 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171100000X , with the licence number: AP544 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171100000X , with the licence number: AP2900 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171100000X , with the licence number: AP2976 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171100000X , with the licence number: AP3608 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT7299 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT22574 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT7339 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: PT9087 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT29612 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT27376 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT25562 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2381853 . This is a "GROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1869541 . This is a "GROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Y923L . This is a "GROUP BCBS PO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Y926B . This is a "GROUP BCBS OB" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Y923D . This is a "GROUP BCBS OC" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: CH2068 . This is a "GROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: K1325 . This is a "PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 014966000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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