MEDICARE: FYZICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1194520106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FYZICAL LLC

Provider Business Mailing Address
First Line	:	2181 WAPPOO DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-2090
Country	:	US
Telephone Number	:	239-989-7575
Fax Number	:

Provider Business Practice Location Address
First Line	:	2048 SAM RITTENBERG BLVD STE 3
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4673
Country	:	US
Telephone Number	:	239-989-7575
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. MICHAEL LAWRENCE BADINO
Credential	:
Telephone Number	:	239-989-7575

Provider Enumeration Date	:	02/14/2025
Last Update Date	:	08/15/2025

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Directions to “FYZICAL LLC ” Practice Location

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