Healthcare Provider Details

I. General information

NPI: 1962503466
Provider Name (Legal Business Name): ALPHA PHYSICAL THERAPY & REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 W ATLANTIC AVE SUITE 500
DELRAY BEACH FL
33484-8165
US

IV. Provider business mailing address

3603 NW 6TH ST
DEERFIELD BEACH FL
33442-8068
US

V. Phone/Fax

Practice location:
  • Phone: 561-638-8821
  • Fax: 561-638-8861
Mailing address:
  • Phone: 407-451-9766
  • Fax: 561-638-8861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2003-12134
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2003-12134
License Number StateFL

VIII. Authorized Official

Name: MS. SUNITA SHARMA
Title or Position: OWNER -
Credential: PT
Phone: 407-451-9766