Provider Demographics
NPI:1659950244
Name:REGENT THERAPY SERVICES LLC.
Entity Type:Organization
Organization Name:REGENT THERAPY SERVICES LLC.
Other - Org Name:FYZICAL THERAPY & BALANCE CENTERS OF LAKE MARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAULIKA
Authorized Official - Middle Name:N
Authorized Official - Last Name:THAKORE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:813-843-2401
Mailing Address - Street 1:5205 PIPER LN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5465
Mailing Address - Country:US
Mailing Address - Phone:813-843-2401
Mailing Address - Fax:
Practice Address - Street 1:875 WALLACE CT , SUITE C (UNIT 1013)
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3274
Practice Address - Country:US
Practice Address - Phone:813-843-2401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty