MEDICARE: SOUTH WALTON PHYSICAL THERAPY AND REHABILITATION, 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	225100000X	Physical Therapist	PT3883	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RG5	OTHER	FL	SRB BCBS PROV#
2	RR2	OTHER	FL	DFS BCBS PROV#
3	7446067	OTHER	FL	JESS'S AETNA PROV#

General Provider Information

NPI Number	:	1497810535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH WALTON PHYSICAL THERAPY AND REHABILITATION, INC

Provider Business Mailing Address
First Line	:	4942 US HIGHWAY 98 W STE 6
Second Line	:
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-4092
Country	:	US
Telephone Number	:	850-267-9010
Fax Number	:	850-267-0677

Provider Business Practice Location Address
First Line	:	4942 US HIGHWAY 98 W STE 6
Second Line	:
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-4092
Country	:	US
Telephone Number	:	850-267-9010
Fax Number	:	850-267-0677

Authorized Official
Title or Position	:	CEO
Name	:	DAVID V MONTELEONE
Credential	:
Telephone Number	:	850-267-9010

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1184345704 — SANTE FE NM CAREGIVING LLC
Practice Location Address:

1441 S SAINT FRANCIS DR STE D
SANTA FE, NM
87505-4092

Practice Phone: 505-666-5825
Practice Fax:

1700884343 — JOSEPH SCOTT WELCH MD
Practice Location Address:

4092 FOXWOOD DR , STE 101
VIRGINIA BEACH, VA
23462-5225

Practice Phone: 757-686-3508
Practice Fax: 757-686-0541

1902887516 — EVAN E JONES PA-C
Practice Location Address:

4092 FOXWOOD DRIVE, SUITE #101 , EMERGENCY PHYSICIANS OF TIDEWATER, PC
VIRGINIA BEACH, VA
23462

Practice Phone: 757-686-3508
Practice Fax: 757-686-0541

1053381806 — DR. SUSAN J LETTERLE M.D.
Practice Location Address:

4092 FOXWOOD DR , STE 101
VIRGINIA BEACH, VA
23462-5225

Practice Phone: 757-467-4200
Practice Fax: 757-686-0541

1922079367 — GEORGE C LUISKUTTY M.D.
Practice Location Address:

4092 FOXWOOD DR , STE 101
VIRGINIA BEACH, VA
23462-5225

Practice Phone: 757-686-3508
Practice Fax: 757-686-0541

1780656652 — DR. JOHN JOSEPH DEVLIN MD
Practice Location Address:

4092 FOXWOOD DR , STE 101
VIRGINIA BEACH, VA
23462-5225

Practice Phone: 757-686-3508
Practice Fax: 757-686-0541

Directions to “SOUTH WALTON PHYSICAL THERAPY AND REHABILITATION, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.