Provider Demographics
NPI:1760846372
Name:TAMPA IN HOME PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:TAMPA IN HOME PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZENDRIE
Authorized Official - Middle Name:ANDINO
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:813-966-4011
Mailing Address - Street 1:16319 HEATHROW DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2640
Mailing Address - Country:US
Mailing Address - Phone:813-966-4011
Mailing Address - Fax:
Practice Address - Street 1:16319 HEATHROW DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2640
Practice Address - Country:US
Practice Address - Phone:813-966-4011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-09
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31136261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy