MEDICARE: PHYSIOTHERAPY PLUS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA 32752	FL
2	225100000X	Physical Therapist	PT 21887	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508817537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOTHERAPY PLUS INC

Provider Business Mailing Address
First Line	:	6388 SILVER STAR RD
Second Line	:	1E
City	:	ORLANDO
State	:	FL
Zip	:	32818-3235
Country	:	US
Telephone Number	:	321-369-9133
Fax Number	:	888-696-1020

Provider Business Practice Location Address
First Line	:	6388 SILVER STAR RD STE 1E
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-3235
Country	:	US
Telephone Number	:	321-369-9133
Fax Number	:	888-696-1020

Authorized Official
Title or Position	:	CLINICAL DIR
Name	:	IDLER BONHOMME
Credential	:	LMT, MPT, DPT
Telephone Number	:	321-369-9133

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	01/05/2021

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Directions to “PHYSIOTHERAPY PLUS INC ” Practice Location

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