=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891167649
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRYE PHYSICAL THERAPY,PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/20/2015
-----------------------------------------------------
Last Update Date | 02/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5432 BEE RIDGE RD STE 110
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-487-8740
-----------------------------------------------------
Fax | 941-487-8739
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5432 BEE RIDGE RD STE 110
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-1512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-487-8740
-----------------------------------------------------
Fax | 941-487-8739
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JAY FRYE
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 941-685-0433
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT25677
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------