Provider Demographics
NPI:1407522832
Name:CATALYST PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:CATALYST PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DIMITRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSTOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT,PHD,DPT,ESC
Authorized Official - Phone:718-707-6970
Mailing Address - Street 1:1206 COURT ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5802
Mailing Address - Country:US
Mailing Address - Phone:727-286-8408
Mailing Address - Fax:727-286-6048
Practice Address - Street 1:1206 COURT STREET
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5802
Practice Address - Country:US
Practice Address - Phone:718-707-6970
Practice Address - Fax:929-208-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty