Provider Demographics
NPI:1700030020
Name:THERAPY AND SPORTS CENTER, INC.
Entity Type:Organization
Organization Name:THERAPY AND SPORTS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-898-5001
Mailing Address - Street 1:13011 SUMMERFIELD SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-7402
Mailing Address - Country:US
Mailing Address - Phone:813-374-2209
Mailing Address - Fax:813-374-2211
Practice Address - Street 1:13011 SUMMERFIELD SQUARE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7402
Practice Address - Country:US
Practice Address - Phone:813-374-2209
Practice Address - Fax:813-374-2211
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERAPY AND SPORTS CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-13
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY930YOtherBC & BS OF FLORIDA PROVIDER NUMBER
FLY930YOtherBC & BS OF FLORIDA PROVIDER NUMBER