Healthcare Provider Details

I. General information

NPI: 1700012747
Provider Name (Legal Business Name): FOUNDATION PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29605 US HIGHWAY 19 N SUITE #360
CLEARWATER FL
33761-1537
US

IV. Provider business mailing address

29605 US HIGHWAY 19 N SUITE #360
CLEARWATER FL
33761-1537
US

V. Phone/Fax

Practice location:
  • Phone: 727-784-6088
  • Fax: 727-784-3034
Mailing address:
  • Phone: 727-784-6088
  • Fax: 727-784-3034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPT 15607
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberPT 15607
License Number StateFL

VIII. Authorized Official

Name: MRS. GINA ARGIRA PARSONIS
Title or Position: VICE-PRESIDENT
Credential: DPT, MTC
Phone: 727-784-6088