Healthcare Provider Details
I. General information
NPI: 1770800336
Provider Name (Legal Business Name): FLEXICARE PHYSICAL THERAPY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2010
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3701 54TH DR W BLDG M-101
BRADENTON FL
34210-3558
US
IV. Provider business mailing address
3701 54TH DR W BLDG M-101
BRADENTON FL
34210-3558
US
V. Phone/Fax
- Phone: 941-751-7505
- Fax: 941-753-6961
- Phone: 941-751-7505
- Fax: 941-753-6961
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251G0304X |
| Taxonomy | Geriatric Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
GENEVIEVE
DACOCO
DUREMDEZ
Title or Position: OWNER
Credential: RPT
Phone: 941-751-7505