MEDICARE: PHYSICAL THERAPY CENTERS OF SOUTH FLORIDA, INC,

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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1437267143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY CENTERS OF SOUTH FLORIDA, INC,

Provider Business Mailing Address
First Line	:	6620 LAKE WORTH RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1518
Country	:	US
Telephone Number	:	561-967-1022
Fax Number	:	561-967-9399

Provider Business Practice Location Address
First Line	:	6620 LAKE WORTH RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1518
Country	:	US
Telephone Number	:	561-967-1022
Fax Number	:	561-967-9399

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. DAVID LIVINGSTON
Credential	:	D.C.
Telephone Number	:	561-967-1022

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	08/22/2020

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