Provider Demographics
NPI:1568498731
Name:EAST COAST PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:EAST COAST PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MURRAY
Authorized Official - Last Name:BREGLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-998-0077
Mailing Address - Street 1:530 IBIS DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-1926
Mailing Address - Country:US
Mailing Address - Phone:561-998-0077
Mailing Address - Fax:561-998-0078
Practice Address - Street 1:4814 NW BOCA RATON BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4818
Practice Address - Country:US
Practice Address - Phone:561-998-0077
Practice Address - Fax:561-998-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT13223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7244Medicare PIN