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NPI Code Detail

MEDICARE: HEALTHY LIFESTYLE PHYSICAL THERAPY

MEDICARE: HEALTHY LIFESTYLE PHYSICAL THERAPY
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1528685666
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHY LIFESTYLE PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 1000 E HILLSBORO BLVD STE 104
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-3628
Country : US
Telephone Number : 917-642-8865
Fax Number :
Provider Business Practice Location Address
First Line : 1000 E HILLSBORO BLVD STE 104
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-3628
Country : US
Telephone Number : 917-642-8865
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DMITRY RUTENBERG
Credential : DPT
Telephone Number : 917-642-8865
Provider Enumeration Date : 07/05/2020
Last Update Date : 08/07/2023

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Directions to “HEALTHY LIFESTYLE PHYSICAL THERAPY ” 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.

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