Healthcare Provider Details

I. General information

NPI: 1760213862
Provider Name (Legal Business Name): FLOW PHYSICAL THERAPY SPORTS PERFORMANCE AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NE 65TH ST APT 335
FORT LAUDERDALE FL
33308-1567
US

IV. Provider business mailing address

2400 NE 65TH ST APT 335
FORT LAUDERDALE FL
33308-1567
US

V. Phone/Fax

Practice location:
  • Phone: 631-612-1448
  • Fax: 954-985-0450
Mailing address:
  • Phone: 631-612-1448
  • Fax: 954-985-0450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA CONNOR
Title or Position: OWNER
Credential: DPT
Phone: 631-612-1448