=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346377892
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MASTERCARE PHYSICAL THERAPY, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2007
-----------------------------------------------------
Last Update Date | 10/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3982 BEE RIDGE RD STE K
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-1210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-377-6700
-----------------------------------------------------
Fax | 941-377-3929
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3982 BEE RIDGE RD STE K
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-1210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-377-6700
-----------------------------------------------------
Fax | 941-377-3929
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | HOLLY MILLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 941-377-6700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT0013941
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------