Provider Demographics
NPI:1467160846
Name:L.I.F.E PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:L.I.F.E PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT, DPT, MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SACHIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINOHARA-LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:917-685-6196
Mailing Address - Street 1:9025 ALEXANDRA CIRC
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414
Mailing Address - Country:US
Mailing Address - Phone:917-685-6196
Mailing Address - Fax:
Practice Address - Street 1:9025 ALEXANDRA CIRC
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:917-685-6196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy