Healthcare Provider Details

I. General information

NPI: 1225527237
Provider Name (Legal Business Name): PINNACLE MOVEMENT AND PERFORMANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 S CONGRESS AVE STE C
DELRAY BEACH FL
33445-7312
US

IV. Provider business mailing address

2855 S CONGRESS AVE STE C
DELRAY BEACH FL
33445-7312
US

V. Phone/Fax

Practice location:
  • Phone: 561-325-8278
  • Fax: 561-962-1567
Mailing address:
  • Phone: 561-325-8278
  • Fax: 561-962-1567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT31829
License Number StateFL

VIII. Authorized Official

Name: DR. ERIC OTERO
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 407-922-7622