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General NPI Number Information
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NPI Number | 1699208686
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Entity Type | Organization
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Legal Business Name | GOLD COAST PHYSICAL THERAPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 04/06/2017
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 901 N FLAGLER DR 1
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City | WEST PALM BEACH
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State | FL
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Zip | 33401
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Country | US
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Telephone | 561-432-0111
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Fax | 561-432-1075
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Provider Business Mailing Address
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Address Line | 5840 CORPORATE WAY STE 101
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2040
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Country | US
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Telephone | 561-432-0111
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Fax | 561-432-1075
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. MICHAEL LEE GRAVES
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Credential | MSPT
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Telephone | 561-432-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | FL
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