Provider Demographics
NPI:1356660690
Name:PEAK PERFORMANCE REHABILITATION, LLC
Entity Type:Organization
Organization Name:PEAK PERFORMANCE REHABILITATION, LLC
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-302-7717
Mailing Address - Street 1:632 N FEDERAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304
Mailing Address - Country:US
Mailing Address - Phone:954-929-3006
Mailing Address - Fax:954-929-2001
Practice Address - Street 1:777 SE 20TH ST STE 200
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-3589
Practice Address - Country:US
Practice Address - Phone:954-302-7717
Practice Address - Fax:754-216-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty