Provider Demographics
NPI:1043263197
Name:LAUDERHILL PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:LAUDERHILL PHYSICAL THERAPY, LLC
Other - Org Name:ADVANCED PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:PIAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:954-572-0777
Mailing Address - Street 1:7175 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1050
Mailing Address - Country:US
Mailing Address - Phone:954-572-0777
Mailing Address - Fax:
Practice Address - Street 1:7175 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1050
Practice Address - Country:US
Practice Address - Phone:954-572-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy