Provider Demographics
NPI:1003224924
Name:BEYOND BASICS PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:BEYOND BASICS PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERZYL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:561-350-5968
Mailing Address - Street 1:21088 MADRIA CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2529
Mailing Address - Country:US
Mailing Address - Phone:407-791-2366
Mailing Address - Fax:
Practice Address - Street 1:7201 B ADDISON RESERVE BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH, FL
Practice Address - State:FL
Practice Address - Zip Code:33446
Practice Address - Country:US
Practice Address - Phone:407-791-2366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2018-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28364261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy