Provider Demographics
NPI:1689687055
Name:PHYSICAL THERAPY BY DESIGN LLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY BY DESIGN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-994-0014
Mailing Address - Street 1:4177 NW 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-5834
Mailing Address - Country:US
Mailing Address - Phone:561-998-4676
Mailing Address - Fax:561-998-4735
Practice Address - Street 1:1905 CLINT MOORE RD
Practice Address - Street 2:SUITE 211, 102
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2658
Practice Address - Country:US
Practice Address - Phone:561-994-0014
Practice Address - Fax:561-994-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6297Medicare ID - Type Unspecified