Provider Demographics
NPI:1659674026
Name:KB FITNESS, LLC
Entity Type:Organization
Organization Name:KB FITNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PARMIGIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:772-485-9447
Mailing Address - Street 1:7361 SE CONCORD PL
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-5885
Mailing Address - Country:US
Mailing Address - Phone:772-485-9447
Mailing Address - Fax:772-781-8801
Practice Address - Street 1:7361 SE CONCORD PL
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-5885
Practice Address - Country:US
Practice Address - Phone:772-485-9447
Practice Address - Fax:772-781-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty