Provider Demographics
NPI:1396372991
Name:BROWARD COUNTY PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:BROWARD COUNTY PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-202-9009
Mailing Address - Street 1:4750 N FEDERAL HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4609
Mailing Address - Country:US
Mailing Address - Phone:954-202-9009
Mailing Address - Fax:954-776-9953
Practice Address - Street 1:4750 N FEDERAL HWY STE 203
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4609
Practice Address - Country:US
Practice Address - Phone:954-202-9009
Practice Address - Fax:954-776-9953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty