Provider Demographics
NPI:1427556893
Name:FLORIDA ORTHOPEDIC AND BALANCE PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:FLORIDA ORTHOPEDIC AND BALANCE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:UCHA
Authorized Official - Middle Name:CHIOMA
Authorized Official - Last Name:UKPAI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS, CMPT
Authorized Official - Phone:954-706-1192
Mailing Address - Street 1:5837 NW 56TH DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3542
Mailing Address - Country:US
Mailing Address - Phone:954-736-7427
Mailing Address - Fax:
Practice Address - Street 1:9850 STIRLING RD STE 100
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8068
Practice Address - Country:US
Practice Address - Phone:954-706-1192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty