Provider Demographics
NPI:1659318293
Name:PHYSIOTHERAPY WORKS, LLC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY WORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:407-657-5029
Mailing Address - Street 1:1860 STATE ROAD 436
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2255
Mailing Address - Country:US
Mailing Address - Phone:407-657-5029
Mailing Address - Fax:407-657-6320
Practice Address - Street 1:1860 STATE ROAD 436
Practice Address - Street 2:SUITE 1000
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2255
Practice Address - Country:US
Practice Address - Phone:407-657-5029
Practice Address - Fax:407-657-6320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20926225100000X
FLPT162192251G0304X, 2251N0400X, 2251S0007X, 2251X0800X
FLMA42422225700000X
FLMA33653225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Single Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMM15854OtherMASSAGE ESTABLISHMENT
K6359Medicare PIN
FLMM15854OtherMASSAGE ESTABLISHMENT