Healthcare Provider Details

I. General information

NPI: 1760104475
Provider Name (Legal Business Name): UNITED THERAPISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4917 NE 14TH TER
POMPANO BEACH FL
33064-5703
US

IV. Provider business mailing address

4917 NE 14TH TER
POMPANO BEACH FL
33064-5703
US

V. Phone/Fax

Practice location:
  • Phone: 954-818-6338
  • Fax: 954-480-9082
Mailing address:
  • Phone: 954-818-6338
  • Fax: 954-480-9082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: STEVEN ROBERT ELLER
Title or Position: PRESIDENT
Credential: PTA
Phone: 954-818-6338