Provider Demographics
NPI:1568556900
Name:HEALING HANDS PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:HEALING HANDS PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PACITA
Authorized Official - Middle Name:MAGANTINO
Authorized Official - Last Name:MANODOM-MISLAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:352-683-6190
Mailing Address - Street 1:7367 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606
Mailing Address - Country:US
Mailing Address - Phone:352-683-6190
Mailing Address - Fax:352-683-6160
Practice Address - Street 1:7367 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606
Practice Address - Country:US
Practice Address - Phone:352-683-6190
Practice Address - Fax:352-683-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10116261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY080BAMedicare ID - Type Unspecified