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General NPI Number Information
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NPI Number | 1497039697
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Entity Type | Organization
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Legal Business Name | ADVANTAGE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 07/19/2024
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Provider Practice Location Address
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Address Line | 3639 W WOOLBRIGHT RD
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-7244
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Country | US
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Telephone | 561-404-0203
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Fax |
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Provider Business Mailing Address
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Address Line | 3639 W WOOLBRIGHT RD
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-7244
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Country | US
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Telephone | 561-404-0203
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Fax | 561-404-0205
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. MARK ANTHONY FORGIONE
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Credential | DPT
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Telephone | 561-846-2748
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT24170
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License Number State | FL
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