Provider Demographics
NPI:1407164841
Name:IN-HOME THERAPY OF CENTRAL FLORIDA INC
Entity Type:Organization
Organization Name:IN-HOME THERAPY OF CENTRAL FLORIDA INC
Other - Org Name:ALL ACTIVE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ANGELIE
Authorized Official - Middle Name:ALCALA
Authorized Official - Last Name:GARAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:352-255-6130
Mailing Address - Street 1:614 E HWY 50 # 129
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-3164
Mailing Address - Country:US
Mailing Address - Phone:352-255-6130
Mailing Address - Fax:407-378-4154
Practice Address - Street 1:3721 S HWY 27 STE B
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7919
Practice Address - Country:US
Practice Address - Phone:352-255-6130
Practice Address - Fax:407-378-4154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
FLPT5880261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty