Healthcare Provider Details

I. General information

NPI: 1396504734
Provider Name (Legal Business Name): WESTCHASE PHYSICAL THERAPY AND MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3953 TAMPA RD STE 102
OLDSMAR FL
34677-3233
US

IV. Provider business mailing address

12705 RACE TRACK RD
TAMPA FL
33626-1314
US

V. Phone/Fax

Practice location:
  • Phone: 813-343-3960
  • Fax: 813-343-3965
Mailing address:
  • Phone: 813-343-3960
  • Fax: 818-343-3965

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: JOHN MAGEE
Title or Position: PRESIDENT
Credential: DPT
Phone: 813-343-3960