Provider Demographics
NPI:1780024224
Name:SHELTON PHYSICAL THERAPY AND REHAB INC
Entity Type:Organization
Organization Name:SHELTON PHYSICAL THERAPY AND REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELCOURT-COUTO
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:305-496-0770
Mailing Address - Street 1:275 FOUNTAINBLEAU BLVD
Mailing Address - Street 2:SUITE 185
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4591
Mailing Address - Country:US
Mailing Address - Phone:305-496-0770
Mailing Address - Fax:
Practice Address - Street 1:275 FOUNTAINBLEAU BLVD
Practice Address - Street 2:SUITE 185
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4591
Practice Address - Country:US
Practice Address - Phone:305-496-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty