Healthcare Provider Details

I. General information

NPI: 1578404596
Provider Name (Legal Business Name): CORE KINETICS PHYSICAL THERAPY & REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10311 NW 11TH ST
PLANTATION FL
33322-6577
US

IV. Provider business mailing address

10311 NW 11TH ST
PLANTATION FL
33322-6577
US

V. Phone/Fax

Practice location:
  • Phone: 954-882-6842
  • Fax:
Mailing address:
  • Phone: 954-882-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALAN MORENO
Title or Position: OWNER
Credential: DR
Phone: 954-882-6842