Healthcare Provider Details

I. General information

NPI: 1720545395
Provider Name (Legal Business Name): PHYSIO CARE PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 PONCE DE LEON AVE
VENICE FL
34285-2330
US

IV. Provider business mailing address

12770 INDIGO BREEZE DR
SARASOTA FL
34238-3519
US

V. Phone/Fax

Practice location:
  • Phone: 484-477-7659
  • Fax: 941-761-5708
Mailing address:
  • Phone: 484-477-7659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: ALLA KRINSKY
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 484-477-7659