Healthcare Provider Details

I. General information

NPI: 1609205673
Provider Name (Legal Business Name): GOLD COAST PHYSICAL THERAPY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2013
Last Update Date: 09/02/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 BROKEN SOUND PKWY NW STE 190
BOCA RATON FL
33487-3505
US

IV. Provider business mailing address

5840 CORPORATE WAY STE 101
WEST PALM BEACH FL
33407-2040
US

V. Phone/Fax

Practice location:
  • Phone: 561-432-0111
  • Fax: 561-432-1075
Mailing address:
  • Phone: 561-432-0111
  • Fax: 561-432-1075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL LEE GRAVES
Title or Position: OWNER/PRESIDENT
Credential: MSPT
Phone: 561-432-0111