Provider Demographics
NPI:1134506868
Name:ANGEL HANDS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ANGEL HANDS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-350-4244
Mailing Address - Street 1:7029 S TAMIAMI TRL
Mailing Address - Street 2:SUITE A
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5552
Mailing Address - Country:US
Mailing Address - Phone:941-924-8000
Mailing Address - Fax:941-924-8003
Practice Address - Street 1:7029 S TAMIAMI TRL
Practice Address - Street 2:SUITE A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5552
Practice Address - Country:US
Practice Address - Phone:941-924-8000
Practice Address - Fax:941-924-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBQ813ZMedicare UPIN