Provider Demographics
NPI:1053447508
Name:WOMENS PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:WOMENS PHYSICAL THERAPY INC
Other - Org Name:WOMENS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DORI
Authorized Official - Middle Name:F
Authorized Official - Last Name:BARENHOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-482-4300
Mailing Address - Street 1:5045 POINTE EMERALD LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486
Mailing Address - Country:US
Mailing Address - Phone:561-395-3609
Mailing Address - Fax:561-482-8855
Practice Address - Street 1:9250 GLADES RD STE 106
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3958
Practice Address - Country:US
Practice Address - Phone:561-482-4300
Practice Address - Fax:561-482-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
FLPT 127712251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2866Medicare ID - Type Unspecified