Healthcare Provider Details

I. General information

NPI: 1689230831
Provider Name (Legal Business Name): HARMONY LYMPH AND PELVIC PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2959 W MIDWAY RD
FORT PIERCE FL
34981-4956
US

IV. Provider business mailing address

5984 NW BAYNARD DR
PORT ST LUCIE FL
34986-3610
US

V. Phone/Fax

Practice location:
  • Phone: 772-342-4490
  • Fax:
Mailing address:
  • Phone: 772-342-4490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ERICA FRANCISCO GOULD
Title or Position: OWENER PT
Credential:
Phone: 772-342-4490