Provider Demographics
NPI:1467571620
Name:OCEAN PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:OCEAN PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:561-775-7775
Mailing Address - Street 1:7100 FAIRWAY DR STE 27
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3782
Mailing Address - Country:US
Mailing Address - Phone:561-775-7775
Mailing Address - Fax:561-775-7807
Practice Address - Street 1:252 S OCEAN BLVD STE A
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-3312
Practice Address - Country:US
Practice Address - Phone:561-588-1343
Practice Address - Fax:561-588-1462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY928MOtherBCBS OF FL
FLAI503Medicare PIN