Provider Demographics
NPI:1437267143
Name:PHYSICAL THERAPY CENTERS OF SOUTH FLORIDA, INC,
Entity Type:Organization
Organization Name:PHYSICAL THERAPY CENTERS OF SOUTH FLORIDA, INC,
Other - Org Name:ADVANCED THERAPY CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-967-1022
Mailing Address - Street 1:6620 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-1518
Mailing Address - Country:US
Mailing Address - Phone:561-967-1022
Mailing Address - Fax:561-967-9399
Practice Address - Street 1:6620 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-1518
Practice Address - Country:US
Practice Address - Phone:561-967-1022
Practice Address - Fax:561-967-9399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104816Medicare ID - Type UnspecifiedCORF PROVIDER NUMBER