Provider Demographics
NPI:1285767228
Name:PHYSIOTHERAPY WORKS LLC
Entity type:Organization
Organization Name:PHYSIOTHERAPY WORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:407-657-5029
Mailing Address - Street 1:PO BOX 4605
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32793-4605
Mailing Address - Country:US
Mailing Address - Phone:407-657-5029
Mailing Address - Fax:407-657-6320
Practice Address - Street 1:1860 STATE ROAD 436
Practice Address - Street 2:SUITE 1000
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792
Practice Address - Country:US
Practice Address - Phone:407-657-5029
Practice Address - Fax:407-657-6320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
FLMM15854225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6359Medicare PIN