Provider Demographics
NPI:1629340807
Name:ORLANDO PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ORLANDO PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARNEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RENTON
Authorized Official - Suffix:III
Authorized Official - Credentials:PT
Authorized Official - Phone:407-273-3100
Mailing Address - Street 1:2014 S ORANGE AVE
Mailing Address - Street 2:200B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3069
Mailing Address - Country:US
Mailing Address - Phone:407-273-3100
Mailing Address - Fax:
Practice Address - Street 1:2014 S ORANGE AVE
Practice Address - Street 2:200B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3069
Practice Address - Country:US
Practice Address - Phone:407-273-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty