Healthcare Provider Details

I. General information

NPI: 1144937012
Provider Name (Legal Business Name): ALIGN PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 S PATRICK DR STE 3
INDIAN HARBOUR BEACH FL
32937-4400
US

IV. Provider business mailing address

2030 S PATRICK DR STE 3
INDIAN HARBOUR BEACH FL
32937-4400
US

V. Phone/Fax

Practice location:
  • Phone: 321-412-8166
  • Fax: 321-622-8557
Mailing address:
  • Phone: 321-622-5707
  • Fax: 321-622-8557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL PHILIP WOLINSKI
Title or Position: V.P. OF ADMINISTRATION
Credential:
Phone: 321-412-8166