Provider Demographics
NPI:1497427413
Name:VERSATILE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:VERSATILE PHYSICAL THERAPY LLC
Other - Org Name:VERSATILE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MG MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS, MTC
Authorized Official - Phone:239-839-9842
Mailing Address - Street 1:320 SPANISH MAIN DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERLAND KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33042-4303
Mailing Address - Country:US
Mailing Address - Phone:239-839-9842
Mailing Address - Fax:865-500-3729
Practice Address - Street 1:1010 KENNEDY DR STE 407
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4134
Practice Address - Country:US
Practice Address - Phone:305-709-1132
Practice Address - Fax:865-500-3729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty