Provider Demographics
NPI:1033529979
Name:EMERALD HILLS PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:EMERALD HILLS PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:TZVETANKA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GRUEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-966-2173
Mailing Address - Street 1:3868 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3623
Mailing Address - Country:US
Mailing Address - Phone:954-989-5225
Mailing Address - Fax:954-962-6445
Practice Address - Street 1:3868 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3623
Practice Address - Country:US
Practice Address - Phone:954-989-5255
Practice Address - Fax:954-962-6445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19559225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty