Healthcare Provider Details

I. General information

NPI: 1467600551
Provider Name (Legal Business Name): PEDIATRIX THERAPIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 PAWLEYS LOOP N
SAINT CLOUD FL
34769-7103
US

IV. Provider business mailing address

3250 PAWLEYS LOOP N
SAINT CLOUD FL
34769-7103
US

V. Phone/Fax

Practice location:
  • Phone: 407-346-5520
  • Fax:
Mailing address:
  • Phone: 407-346-5520
  • Fax:

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: PETRIC MAR D BALBONTIN
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 407-346-5520