Provider Demographics
NPI:1821014069
Name:APEX PHYSICAL THERAPY OF SOUTHWEST FLORIDA, INC.
Entity Type:Organization
Organization Name:APEX PHYSICAL THERAPY OF SOUTHWEST FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:MCGILVREY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:239-337-2739
Mailing Address - Street 1:15751 SAN CARLOS BLVD
Mailing Address - Street 2:SUITE #4
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-3314
Mailing Address - Country:US
Mailing Address - Phone:239-337-2739
Mailing Address - Fax:239-337-2738
Practice Address - Street 1:15751 SAN CARLOS BLVD
Practice Address - Street 2:SUITE #4
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3314
Practice Address - Country:US
Practice Address - Phone:239-337-2739
Practice Address - Fax:239-337-2738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL057304225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8776Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER