Healthcare Provider Details

I. General information

NPI: 1598869612
Provider Name (Legal Business Name): ADVANCED HEALTH PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 03/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7796 NW 44TH ST
LAUDERHILL FL
33351-6204
US

IV. Provider business mailing address

966 NAUTILUS ISLE
DANIA BEACH FL
33004-2356
US

V. Phone/Fax

Practice location:
  • Phone: 954-353-8847
  • Fax: 954-533-2852
Mailing address:
  • Phone: 954-476-5928
  • Fax: 954-530-7240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17717
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number11462
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0001575
License Number StateFL

VIII. Authorized Official

Name: MR. DANIELE B D'AMBROSIO
Title or Position: PRESIDENT
Credential: MPT
Phone: 954-608-3075