Provider Demographics
NPI:1659359511
Name:DAVID STEVENSON PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:DAVID STEVENSON PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-330-1677
Mailing Address - Street 1:2055 WOOD ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-7928
Mailing Address - Country:US
Mailing Address - Phone:941-330-1677
Mailing Address - Fax:941-330-1688
Practice Address - Street 1:2055 WOOD ST STE 110
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-7928
Practice Address - Country:US
Practice Address - Phone:941-330-1677
Practice Address - Fax:941-330-1688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-02
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT4117225100000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4418Medicare ID - Type UnspecifiedGROUP ID NUMBER