Provider Demographics
NPI:1598307993
Name:INTEGUMENTARY PHYSIOTHERAPY INSTITUTE, LLC
Entity Type:Organization
Organization Name:INTEGUMENTARY PHYSIOTHERAPY INSTITUTE, LLC
Other - Org Name:INTEGUMENTARY PHYSIOTHERAPY CLINIC, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NILMA
Authorized Official - Middle Name:ZULEIKA
Authorized Official - Last Name:ELIAS SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:321-972-3238
Mailing Address - Street 1:587 E STATE ROAD 434 UNIT 1021
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-5284
Mailing Address - Country:US
Mailing Address - Phone:321-972-3238
Mailing Address - Fax:
Practice Address - Street 1:587 E STATE ROAD 434 UNIT 1021
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5284
Practice Address - Country:US
Practice Address - Phone:321-972-3238
Practice Address - Fax:321-972-3590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Single Specialty