Provider Demographics
NPI:1982801882
Name:FLORIDA SKILLED THERAPY SERVICES INC
Entity type:Organization
Organization Name:FLORIDA SKILLED THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALIVIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-409-9370
Mailing Address - Street 1:1857 WOODPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-2876
Mailing Address - Country:US
Mailing Address - Phone:863-409-9370
Mailing Address - Fax:863-307-3211
Practice Address - Street 1:304 DUNDEE RD STE A
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:FL
Practice Address - Zip Code:33838-4176
Practice Address - Country:US
Practice Address - Phone:863-286-9289
Practice Address - Fax:863-307-3211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20985225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8526Medicare ID - Type UnspecifiedMEDICARE GRP NUMBER