Provider Demographics
NPI:1124324363
Name:PRIBILA CONSULTING SERVICES INC
Entity type:Organization
Organization Name:PRIBILA CONSULTING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:PRIBILA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:863-614-7882
Mailing Address - Street 1:917 ASHTON OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-5658
Mailing Address - Country:US
Mailing Address - Phone:813-876-8771
Mailing Address - Fax:
Practice Address - Street 1:1826 N CRYSTAL LAKE DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5905
Practice Address - Country:US
Practice Address - Phone:813-876-8771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-06
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21113261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy