Healthcare Provider Details

I. General information

NPI: 1528165040
Provider Name (Legal Business Name): PHYSICAL THERAPY AND FITNESS INSTITUTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 11/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 SE OCEAN BLVD
STUART FL
34996-3304
US

IV. Provider business mailing address

2020 SE OCEAN BLVD
STUART FL
34996-3304
US

V. Phone/Fax

Practice location:
  • Phone: 772-287-8511
  • Fax: 772-223-0565
Mailing address:
  • Phone: 772-287-8511
  • Fax: 772-223-0565

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: MR. JOSEPH P CANDELA
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: P.T.
Phone: 772-287-8511