Healthcare Provider Details

I. General information

NPI: 1679407613
Provider Name (Legal Business Name): TOP PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 94TH ST APT 212
BAY HARBOR ISLANDS FL
33154-2357
US

IV. Provider business mailing address

1080 94TH ST APT 212
BAY HARBOR ISLANDS FL
33154-2357
US

V. Phone/Fax

Practice location:
  • Phone: 302-528-4820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ETHAN LAWRENCE GOLDSTEIN
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 302-528-4820