Healthcare Provider Details

I. General information

NPI: 1639618804
Provider Name (Legal Business Name): PHYSIOTHERAPY & SPORTS REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 MILITARY TRL SUITE 208
JUPITER FL
33458-7801
US

IV. Provider business mailing address

PO BOX 1184
JUPITER FL
33468-1184
US

V. Phone/Fax

Practice location:
  • Phone: 561-575-6811
  • Fax:
Mailing address:
  • Phone: 561-575-6811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH G ALESSI
Title or Position: OWNER
Credential: DPT
Phone: 561-575-6811