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General NPI Number Information
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NPI Number | 1598270407
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Entity Type | Organization
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Legal Business Name | TOTAL THERAPY FLORIDA, LLC
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 1499 E VENICE AVE UNIT A
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City | VENICE
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State | FL
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Zip | 34292-3207
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Country | US
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Telephone | 941-451-8657
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Fax | 941-218-5630
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Provider Business Mailing Address
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Address Line | 3650 N ACCESS RD
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City | ENGLEWOOD
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State | FL
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Zip | 34224-8655
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Country | US
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Telephone | 941-460-3831
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Fax | 941-218-5627
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN W. STIVER
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Credential | DPT
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Telephone | 941-468-7202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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