Healthcare Provider Details

I. General information

NPI: 1972548022
Provider Name (Legal Business Name): FLORIDA THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 09/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 W 15TH ST
PANAMA CITY FL
32401-1366
US

IV. Provider business mailing address

2711 W 15TH ST
PANAMA CITY FL
32401-1366
US

V. Phone/Fax

Practice location:
  • Phone: 850-769-6001
  • Fax: 850-769-6003
Mailing address:
  • Phone: 850-769-6001
  • Fax: 850-769-6003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateFL

VIII. Authorized Official

Name: MR. JAMES ROLLIN CABLE
Title or Position: CHAIRMAN
Credential:
Phone: 850-769-6001