Provider Demographics
NPI:1326633165
Name:PHYSICAL THERAPY NOW SANFORD LLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY NOW SANFORD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHADI
Authorized Official - Middle Name:
Authorized Official - Last Name:AWWAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-628-2759
Mailing Address - Street 1:241 BELLAGIO CIR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5001
Mailing Address - Country:US
Mailing Address - Phone:305-570-1666
Mailing Address - Fax:305-203-0546
Practice Address - Street 1:241 BELLAGIO CIR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-5001
Practice Address - Country:US
Practice Address - Phone:305-570-1666
Practice Address - Fax:305-203-0546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT19324OtherMEDICAL LICENSE