Healthcare Provider Details

I. General information

NPI: 1689220683
Provider Name (Legal Business Name): TONY CERRA PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 NE 37TH CT
LIGHTHOUSE POINT FL
33064-3909
US

IV. Provider business mailing address

2265 NE 37TH CT
LIGHTHOUSE POINT FL
33064-3909
US

V. Phone/Fax

Practice location:
  • Phone: 585-469-5832
  • Fax:
Mailing address:
  • Phone: 585-469-5832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY J CERRA
Title or Position: OWNER/MANAGER
Credential: THERAPIST
Phone: 585-469-5832