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General NPI Number Information
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NPI Number | 1235137027
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Entity Type | Organization
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Legal Business Name | ADVANCED ORTHOPAEDIC & SPORTS PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 1896 PALM BEACH LAKES BLVD SUITE B
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-3513
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Country | US
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Telephone | 561-371-6021
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Fax | 561-686-4815
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Provider Business Mailing Address
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Address Line | 1896 PALM BEACH LAKES BLVD SUITE B
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-3513
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Country | US
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Telephone | 561-371-6021
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Fax | 561-686-4815
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MR. DANIEL GOLDSTEIN
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Credential | P.T., O.C.S., S.C.S.
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Telephone | 561-371-6021
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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 | PT0003382
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License Number State | FL
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