Provider Demographics
NPI:1346407913
Name:PRO THERAPY SERVICES INC
Entity Type:Organization
Organization Name:PRO THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUREA
Authorized Official - Middle Name:P
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:239-464-0491
Mailing Address - Street 1:6500 MAYTREE CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-8603
Mailing Address - Country:US
Mailing Address - Phone:239-464-0491
Mailing Address - Fax:
Practice Address - Street 1:6500 MAYTREE CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-8603
Practice Address - Country:US
Practice Address - Phone:239-464-0491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT16830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3957Medicare PIN