Healthcare Provider Details

I. General information

NPI: 1093085607
Provider Name (Legal Business Name): FLORIDA INTERNATIONAL PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 BEE RIDGE RD
SARASOTA FL
34239-6108
US

IV. Provider business mailing address

1887 BUCCANEER CIR
SARASOTA FL
34231-5401
US

V. Phone/Fax

Practice location:
  • Phone: 941-954-3700
  • Fax: 941-923-3882
Mailing address:
  • Phone: 941-302-8549
  • Fax: 941-921-6999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE M JACOBSON
Title or Position: PRESIDENT/OWNER
Credential: PT
Phone: 941-954-3700