1235223280 NPI number — PHYSICAL THERAPY OPTIONS INC

Table of content: (NPI 1235223280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235223280 NPI number — PHYSICAL THERAPY OPTIONS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHYSICAL THERAPY OPTIONS 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:
Provider Other Organization Name Type Code:
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:
1235223280
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7230
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH PORT
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34290-0230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-828-3641
Provider Business Mailing Address Fax Number:
941-828-3641

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13823 TAMIAMI TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH PORT
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34287-2069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-486-8126
Provider Business Practice Location Address Fax Number:
941-412-3599
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BETANCOURT
Authorized Official First Name:
OCIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
941-234-0339

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DC8607 . This is a "RAILROAD PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".




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