Healthcare Provider Details

I. General information

NPI: 1952872368
Provider Name (Legal Business Name): FLORIDA PHYSICAL THERAPY & OCCUPATIONAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2018
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 BELMONT CIR SW
VERO BEACH FL
32968-6714
US

IV. Provider business mailing address

1725 BELMONT CIR SW
VERO BEACH FL
32968-6714
US

V. Phone/Fax

Practice location:
  • Phone: 608-738-9129
  • Fax:
Mailing address:
  • Phone: 608-738-9129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. SHEKDON D HIRSCHUBER
Title or Position: OWNER/MANAGER
Credential:
Phone: 608-738-9129