Provider Demographics
NPI:1265657555
Name:ADVANCED PHYSICAL THERAPY OF CENTRAL FLORIDA INC
Entity Type:Organization
Organization Name:ADVANCED PHYSICAL THERAPY OF CENTRAL FLORIDA INC
Other - Org Name:HOUSECALLS THERAPY SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:III
Authorized Official - Credentials:PT
Authorized Official - Phone:352-693-3378
Mailing Address - Street 1:303 SE 17TH ST
Mailing Address - Street 2:#309-217
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4467
Mailing Address - Country:US
Mailing Address - Phone:352-693-3378
Mailing Address - Fax:888-758-9645
Practice Address - Street 1:5036 SE 110TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-3759
Practice Address - Country:US
Practice Address - Phone:352-693-3378
Practice Address - Fax:888-758-9645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAG560OtherMEDICARE PART B
FLAG560OtherMEDICARE PART B