Provider Demographics
NPI:1154182533
Name:LUVBUGS PEDIATRIC PHYSICAL THERAPY
Entity type:Organization
Organization Name:LUVBUGS PEDIATRIC PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISONE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-451-7730
Mailing Address - Street 1:1155 COLUMBINE RD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-2904
Mailing Address - Country:US
Mailing Address - Phone:716-208-5934
Mailing Address - Fax:
Practice Address - Street 1:1155 COLUMBINE RD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-2904
Practice Address - Country:US
Practice Address - Phone:716-208-5934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty