Provider Demographics
NPI:1790790541
Name:SPIROFF INC
Entity Type:Organization
Organization Name:SPIROFF INC
Other - Org Name:HOMESTEAD PHYSICAL THERAPY AND REHABILITATION INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SPIROFF
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:305-245-4905
Mailing Address - Street 1:2004 NORTH KROME AVENUE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-3242
Mailing Address - Country:US
Mailing Address - Phone:305-245-4905
Mailing Address - Fax:305-245-9819
Practice Address - Street 1:2004 NORTH KROME AVENUE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-3242
Practice Address - Country:US
Practice Address - Phone:305-245-4905
Practice Address - Fax:305-245-9819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2381101OtherUNITED HEALTHCARE
FL09133OtherSTAYWELL
FL12018OtherFOUNDATION HEALTH
FL2600694OtherCIGNA
FL09133OtherWELLCARE
FLY8763Medicare ID - Type Unspecified