Provider Demographics
NPI:1407670235
Name:IN-DEPTH CARE PHYSICAL THERAPY
Entity type:Organization
Organization Name:IN-DEPTH CARE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHEN-HSI
Authorized Official - Middle Name:
Authorized Official - Last Name:HSIAO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:407-308-1269
Mailing Address - Street 1:1866 STONEHILL CV
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-6242
Mailing Address - Country:US
Mailing Address - Phone:407-308-1269
Mailing Address - Fax:
Practice Address - Street 1:331 N MAITLAND AVE STE B4
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4753
Practice Address - Country:US
Practice Address - Phone:407-308-1269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty