Healthcare Provider Details

I. General information

NPI: 1871606319
Provider Name (Legal Business Name): DONN W. CROTHERS P.T.A./L.M.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 SW 186TH AVE
SOUTHWEST RANCHES FL
33332-1414
US

IV. Provider business mailing address

5330 SW 186TH AVE
SOUTHWEST RANCHES FL
33332-1414
US

V. Phone/Fax

Practice location:
  • Phone: 954-384-2977
  • Fax: 954-384-8241
Mailing address:
  • Phone: 954-384-2977
  • Fax: 954-384-8241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA002200
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA2739
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: