Provider Demographics
NPI:1033258199
Name:PRIETO PHYSICAL THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:PRIETO PHYSICAL THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRIETO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:352-341-4600
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-0597
Mailing Address - Country:US
Mailing Address - Phone:352-341-4600
Mailing Address - Fax:352-560-4224
Practice Address - Street 1:832 US HIGHWAY 41 S
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34450-6859
Practice Address - Country:US
Practice Address - Phone:352-341-4600
Practice Address - Fax:352-560-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2010-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2849Medicare ID - Type UnspecifiedMEDICARE GROUP #