Provider Demographics
NPI:1073654810
Name:EKES, STEPHEN (MPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:EKES
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 N LOCKWOOD RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-3218
Mailing Address - Country:US
Mailing Address - Phone:941-488-8500
Mailing Address - Fax:941-866-7515
Practice Address - Street 1:1575 N LOCKWOOD RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-3218
Practice Address - Country:US
Practice Address - Phone:941-488-8500
Practice Address - Fax:941-866-7515
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18504225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270019248OtherTAX ID
FL270019248OtherTAX ID