Provider Demographics
NPI:1497496046
Name:TALLAHASSEE PHYSICAL THERAPY & REHABILITATION SERVICES II LLC
Entity Type:Organization
Organization Name:TALLAHASSEE PHYSICAL THERAPY & REHABILITATION SERVICES II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PANFILO
Authorized Official - Middle Name:DEMAGAJES
Authorized Official - Last Name:DEMAYO
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:850-877-8177
Mailing Address - Street 1:132 SALEM CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2810
Mailing Address - Country:US
Mailing Address - Phone:850-877-8177
Mailing Address - Fax:850-942-0128
Practice Address - Street 1:132 SALEM CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2810
Practice Address - Country:US
Practice Address - Phone:850-877-8177
Practice Address - Fax:850-942-0128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty