Provider Demographics
NPI:1790930865
Name:LARRY D PINKUS RPT AP LLC
Entity Type:Organization
Organization Name:LARRY D PINKUS RPT AP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PINKUS
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:407-658-1341
Mailing Address - Street 1:10967 LAKE UNDERHILL RD
Mailing Address - Street 2:SUITE#109
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-4457
Mailing Address - Country:US
Mailing Address - Phone:407-658-1341
Mailing Address - Fax:407-658-1341
Practice Address - Street 1:10967 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE#109
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4457
Practice Address - Country:US
Practice Address - Phone:407-658-1341
Practice Address - Fax:407-658-1341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT2580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty