Provider Demographics
NPI:1508811985
Name:CHOLAKIS, PETER (PT)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:CHOLAKIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300 JOG ROAD
Mailing Address - Street 2:SUITE 107-108
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2164
Mailing Address - Country:US
Mailing Address - Phone:561-742-5959
Mailing Address - Fax:561-495-3886
Practice Address - Street 1:8198 JOG RD.
Practice Address - Street 2:#100
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-2998
Practice Address - Country:US
Practice Address - Phone:561-742-5959
Practice Address - Fax:561-495-3886
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist