Provider Demographics
NPI:1568836435
Name:LIQUIDAYS
Entity Type:Organization
Organization Name:LIQUIDAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PTA
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:YOUSSEF
Authorized Official - Last Name:NASSIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-512-7532
Mailing Address - Street 1:2554 BIG PINE DR
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-8778
Mailing Address - Country:US
Mailing Address - Phone:727-512-7532
Mailing Address - Fax:
Practice Address - Street 1:2554 BIG PINE DR
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-8778
Practice Address - Country:US
Practice Address - Phone:727-512-7532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24820261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy