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General NPI Number Information
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NPI Number | 1164627899
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Entity Type | Organization
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Legal Business Name | FALL PREVENTION HOME PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 1000 NE 4TH CT
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3529
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Country | US
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Telephone | 954-643-4493
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Fax | 954-457-8516
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Provider Business Mailing Address
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Address Line | 1000 NE 4TH CT
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3529
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Country | US
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Telephone | 954-643-4493
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Fax | 954-457-8516
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. EMILIA ANDRIESCU
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Credential | PT
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Telephone | 954-643-4493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 21430
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License Number State | FL
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