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General NPI Number Information
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NPI Number | 1205889714
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Entity Type | Organization
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Legal Business Name | SUNRISE PHYSICAL THERAPY AND REHAB, INC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 1501 PRESIDENTIAL WAY STE 20
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-1852
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Country | US
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Telephone | 561-684-6811
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Fax | 561-684-6812
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Provider Business Mailing Address
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Address Line | 1501 PRESIDENTIAL WAY STE 20
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-1852
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Country | US
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Telephone | 561-684-6811
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Fax | 561-684-6812
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Authorized Official
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Title or Position | PT/VP
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Name | MR. BENSON P BAGASAN
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Credential | PT
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Telephone | 561-732-2422
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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 | 7481
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 8860
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License Number State | FL
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