Provider Demographics
NPI:1568417566
Name:SHIMONY, ADI BENITAH (MPT)
Entity Type:Individual
Prefix:MRS
First Name:ADI
Middle Name:BENITAH
Last Name:SHIMONY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 N. PINE ISLAND ROAD
Mailing Address - Street 2:SUNRISE MEDICAL GROUP
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351
Mailing Address - Country:US
Mailing Address - Phone:954-653-3625
Mailing Address - Fax:954-653-3675
Practice Address - Street 1:3540 N. PINE ISLAND ROAD
Practice Address - Street 2:SUNRISE MEDICAL GROUP
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:954-653-3625
Practice Address - Fax:954-653-3675
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist