Provider Demographics
NPI:1659352078
Name:SLAINTE INC
Entity Type:Organization
Organization Name:SLAINTE INC
Other - Org Name:SLAINTE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:ALIZABETH
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:813-985-8878
Mailing Address - Street 1:5208 E FOWLER AVE
Mailing Address - Street 2:STE 4
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1906
Mailing Address - Country:US
Mailing Address - Phone:813-985-8878
Mailing Address - Fax:813-985-7798
Practice Address - Street 1:5208 E FOWLER AVE
Practice Address - Street 2:STE 4
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-1906
Practice Address - Country:US
Practice Address - Phone:813-985-8878
Practice Address - Fax:813-985-7798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0013284261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY8055OtherBCBS
FL1=========OtherEIN
FLY8055OtherBCBS