Provider Demographics
NPI:1508134586
Name:RICK HAUPT PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:RICK HAUPT PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAUPT
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:941-356-4355
Mailing Address - Street 1:874 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-2374
Mailing Address - Country:US
Mailing Address - Phone:941-356-4355
Mailing Address - Fax:
Practice Address - Street 1:2999 S TAMIAMI TRL
Practice Address - Street 2:SUITE 2
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5106
Practice Address - Country:US
Practice Address - Phone:941-955-1239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18994261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy