Healthcare Provider Details

I. General information

NPI: 1518448257
Provider Name (Legal Business Name): FYZ-PINSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 SUNTREE PL
MELBOURNE FL
32940-7600
US

IV. Provider business mailing address

627 LOGGERHEAD ISLAND DR
SATELLITE BEACH FL
32937-3849
US

V. Phone/Fax

Practice location:
  • Phone: 321-254-5300
  • Fax:
Mailing address:
  • Phone: 321-693-6474
  • Fax: 321-254-5301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANGELA PINSON
Title or Position: OWNER/PRESIDENT
Credential: AU.D
Phone: 321-693-6474