Healthcare Provider Details

I. General information

NPI: 1518566835
Provider Name (Legal Business Name): PERSONAL CARE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HERITAGE DR STE 457
JUPITER FL
33458-2777
US

IV. Provider business mailing address

601 HERITAGE DR STE 457
JUPITER FL
33458-2777
US

V. Phone/Fax

Practice location:
  • Phone: 772-238-0702
  • Fax: 772-237-5823
Mailing address:
  • Phone: 772-238-0702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JAMES L RAYTSIN
Title or Position: OWNER
Credential: PT, DPT
Phone: 772-238-0702