Provider Demographics
NPI:1124153226
Name:SOTERIA PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:SOTERIA PHYSICAL THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELYN-LEA
Authorized Official - Middle Name:
Authorized Official - Last Name:YURKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-531-4700
Mailing Address - Street 1:13787 BELCHER RD S
Mailing Address - Street 2:SUITE 140
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-4065
Mailing Address - Country:US
Mailing Address - Phone:727-531-4700
Mailing Address - Fax:727-531-4799
Practice Address - Street 1:13787 BELCHER RD S
Practice Address - Street 2:SUITE 140
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-4065
Practice Address - Country:US
Practice Address - Phone:727-531-4700
Practice Address - Fax:727-531-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
9563113OtherCIGNA
7258782OtherAETNA
FLY925GOtherBLUE CROSS BLUE SHEILD
FLY925GOtherBLUE CROSS BLUE SHEILD