Provider Demographics
NPI:1396404927
Name:ALL BREVARD COUNTY THERAPY STAFFING INC.
Entity Type:Organization
Organization Name:ALL BREVARD COUNTY THERAPY STAFFING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BALGO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:321-917-4435
Mailing Address - Street 1:711 WICKHAM LAKES DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-2227
Mailing Address - Country:US
Mailing Address - Phone:321-917-4435
Mailing Address - Fax:
Practice Address - Street 1:711 WICKHAM LAKES DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2227
Practice Address - Country:US
Practice Address - Phone:321-917-4435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty