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General NPI Number Information
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NPI Number | 1518055722
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Entity Type | Organization
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Legal Business Name | PT RPT INC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1931 SABAL PALM DR APT. 103
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City | DAVIE
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State | FL
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Zip | 33324-5960
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Country | US
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Telephone | 954-610-5620
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Fax | 954-370-9700
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Provider Business Mailing Address
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Address Line | 1931 SABAL PALM DR APT 103
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City | DAVIE
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State | FL
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Zip | 33324
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Country | US
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Telephone | 954-370-9700
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Fax | 954-370-9700
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. PHYLLIS E TANZER
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Credential | RPT
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Telephone | 954-370-9700
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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 | PT6667
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License Number State | FL
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