Healthcare Provider Details

I. General information

NPI: 1164234738
Provider Name (Legal Business Name): IRA BOND JR. PT,DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 03/26/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 POWERLINE RD STE 3A-B
FORT LAUDERDALE FL
33309-3172
US

IV. Provider business mailing address

5300 POWERLINE RD
FORT LAUDERDALE FL
33309-3172
US

V. Phone/Fax

Practice location:
  • Phone: 954-940-0718
  • Fax: 954-510-9395
Mailing address:
  • Phone: 267-265-0826
  • Fax: 954-510-9395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT42911
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: