Provider Demographics
NPI:1487878450
Name:POSITIVE CARE REHABILITATION THERAPIES, LLC
Entity type:Organization
Organization Name:POSITIVE CARE REHABILITATION THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PHYSICAL THERAPISTS
Authorized Official - Prefix:MR
Authorized Official - First Name:DEXTER
Authorized Official - Middle Name:NOLAND
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:941-747-5847
Mailing Address - Street 1:502 5TH AVENUE DR E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-2006
Mailing Address - Country:US
Mailing Address - Phone:941-747-5847
Mailing Address - Fax:941-747-4865
Practice Address - Street 1:502 5TH AVENUE DR E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-2006
Practice Address - Country:US
Practice Address - Phone:941-747-5847
Practice Address - Fax:941-747-4865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT4414225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4307Medicare ID - Type UnspecifiedGROUP NUMBER