Healthcare Provider Details

I. General information

NPI: 1720816283
Provider Name (Legal Business Name): ISLAND MOBILE PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

476 HIGHWAY A1A STE 1B
SATELLITE BEACH FL
32937-2331
US

IV. Provider business mailing address

476 HIGHWAY A1A STE 1B
SATELLITE BEACH FL
32937-2331
US

V. Phone/Fax

Practice location:
  • Phone: 321-408-4603
  • Fax: 321-294-2343
Mailing address:
  • Phone: 321-408-4603
  • Fax: 321-294-2343

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: MRS. LAURA AITKEN HILL
Title or Position: OWNER/PT
Credential: PT DPT
Phone: 321-536-0424