Provider Demographics
NPI:1285965558
Name:ADVANCED PHYSICAL THERAPY OF CENTRAL FLORIDA INC
Entity type:Organization
Organization Name:ADVANCED PHYSICAL THERAPY OF CENTRAL FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:III
Authorized Official - Credentials:PT
Authorized Official - Phone:352-693-3378
Mailing Address - Street 1:1202 SW 17TH ST
Mailing Address - Street 2:#209-229
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-1271
Mailing Address - Country:US
Mailing Address - Phone:352-693-3378
Mailing Address - Fax:888-758-9645
Practice Address - Street 1:3845 SE LAKE WEIR AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-9153
Practice Address - Country:US
Practice Address - Phone:352-347-1111
Practice Address - Fax:888-758-9645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAG560OtherMEDICARE PTAN