Healthcare Provider Details

I. General information

NPI: 1043991334
Provider Name (Legal Business Name): UPRIGHT PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11921 S DIXIE HWY STE 209
PINECREST FL
33156-4449
US

IV. Provider business mailing address

11921 S DIXIE HWY STE 209
PINECREST FL
33156-4449
US

V. Phone/Fax

Practice location:
  • Phone: 305-431-4422
  • Fax:
Mailing address:
  • Phone: 305-431-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: REBECA CORREALIMA
Title or Position: OWNER
Credential: DPT
Phone: 305-431-4422