Provider Demographics
NPI:1053670463
Name:HEALTHWORX PHYSICAL THERAPY CENTERS LLC
Entity Type:Organization
Organization Name:HEALTHWORX PHYSICAL THERAPY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGMR
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MAPT
Authorized Official - Phone:561-702-3838
Mailing Address - Street 1:9101 LAKERIDGE BLVD
Mailing Address - Street 2:STE 23
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2181
Mailing Address - Country:US
Mailing Address - Phone:561-477-6926
Mailing Address - Fax:
Practice Address - Street 1:7318 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2529
Practice Address - Country:US
Practice Address - Phone:561-702-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10059261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106955Medicare UPIN