Provider Demographics
NPI:1427074723
Name:PHYSICAL THERAPY ASSOCIATES OF SOUTH FLORIDA PA
Entity type:Organization
Organization Name:PHYSICAL THERAPY ASSOCIATES OF SOUTH FLORIDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:954-951-6699
Mailing Address - Street 1:934 N UNIVERSITY DR PMB 204
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7029
Mailing Address - Country:US
Mailing Address - Phone:954-755-1911
Mailing Address - Fax:954-345-6903
Practice Address - Street 1:7171 N UNIVERSITY DR STE 300
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2902
Practice Address - Country:US
Practice Address - Phone:954-951-6699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0005152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00123606OtherRAILROAD MEDICARE
FLY914KOtherBCBS
FLY914KOtherBCBS