Provider Demographics
NPI:1376281295
Name:PELVIC THERAPY SOUTH FLORIDA, LLC
Entity Type:Organization
Organization Name:PELVIC THERAPY SOUTH FLORIDA, LLC
Other - Org Name:KINDBODY PHYSICAL THERAPY AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GATTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-620-1163
Mailing Address - Street 1:185 SW 7TH ST APT 3701
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2984
Mailing Address - Country:US
Mailing Address - Phone:773-620-1163
Mailing Address - Fax:
Practice Address - Street 1:4100 SALZEDO ST STE 6
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1751
Practice Address - Country:US
Practice Address - Phone:773-620-1163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy