Healthcare Provider Details
I. General information
NPI: 1477356871
Provider Name (Legal Business Name): ELITE PHYSICAL THERAPY AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/31/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
960 ENGLISH TOWN LN APT 312
WINTER SPRINGS FL
32708-4680
US
IV. Provider business mailing address
960 ENGLISH TOWN LN APT 312
WINTER SPRINGS FL
32708-4680
US
V. Phone/Fax
- Phone: 754-234-2738
- Fax:
- Phone: 754-234-2738
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NICHOLAS
J
COLETTI
Title or Position: OWNER
Credential: PT, DPT
Phone: 754-234-2738