Provider Demographics
NPI:1518931575
Name:FLORIDA FITNESS AND REHABILITATION, INC.
Entity Type:Organization
Organization Name:FLORIDA FITNESS AND REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:HUGH
Authorized Official - Last Name:MULVEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:239-731-6222
Mailing Address - Street 1:18900 N TAMIAMI TRL
Mailing Address - Street 2:SUITE A-5
Mailing Address - City:N FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-7312
Mailing Address - Country:US
Mailing Address - Phone:239-731-6222
Mailing Address - Fax:239-731-6555
Practice Address - Street 1:18900 N TAMIAMI TRL
Practice Address - Street 2:SUITE A-5
Practice Address - City:N FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-7312
Practice Address - Country:US
Practice Address - Phone:239-731-6222
Practice Address - Fax:239-731-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5021OtherMEDICARE PTAN
FLK5021OtherMEDICARE PTAN