Provider Demographics
NPI:1508389008
Name:HARRY PHYSICAL THERAPY & WELLNESS, PLLC
Entity Type:Organization
Organization Name:HARRY PHYSICAL THERAPY & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FITZHERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRY
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT
Authorized Official - Phone:407-663-7013
Mailing Address - Street 1:2767 GROTTO PL
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6851
Mailing Address - Country:US
Mailing Address - Phone:407-663-7013
Mailing Address - Fax:855-899-5438
Practice Address - Street 1:2767 GROTTO PL
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6851
Practice Address - Country:US
Practice Address - Phone:407-663-7013
Practice Address - Fax:855-899-5438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30848261QP2000X
261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation