Provider Demographics
NPI:1215625447
Name:PHYSICAL THERAPY NOW FORT MYERS
Entity type:Organization
Organization Name:PHYSICAL THERAPY NOW FORT MYERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:305-244-5883
Mailing Address - Street 1:12277 SW 130TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6218
Mailing Address - Country:US
Mailing Address - Phone:305-470-9399
Mailing Address - Fax:305-203-0546
Practice Address - Street 1:11621 S CLEVELAND AVE STE 50
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2866
Practice Address - Country:US
Practice Address - Phone:239-533-9903
Practice Address - Fax:239-307-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT11471OtherMEDICAL LICENSE