Provider Demographics
NPI:1568927358
Name:PUNTA GORDA PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PUNTA GORDA PHYSICAL THERAPY
Other - Org Name:SIFRIT SPORTS REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:HARPER
Authorized Official - Last Name:SIFRIT
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:941-621-4354
Mailing Address - Street 1:2905 TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-7272
Mailing Address - Country:US
Mailing Address - Phone:941-621-4354
Mailing Address - Fax:941-348-1518
Practice Address - Street 1:2905 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-7272
Practice Address - Country:US
Practice Address - Phone:941-258-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy