Provider Demographics
NPI:1528458874
Name:FLOOR PT INC
Entity type:Organization
Organization Name:FLOOR PT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANUJA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTORATE
Authorized Official - Phone:760-502-6111
Mailing Address - Street 1:4764 CRATER RIM RD
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-5548
Mailing Address - Country:US
Mailing Address - Phone:760-502-6111
Mailing Address - Fax:760-683-3286
Practice Address - Street 1:910 W SAN MARCOS BLVD
Practice Address - Street 2:STE 109
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-1115
Practice Address - Country:US
Practice Address - Phone:760-502-6111
Practice Address - Fax:760-683-3286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36437225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty