Provider Demographics
NPI:1821170820
Name:ABERDEEN PHYSICAL THERPY, LLC
Entity Type:Organization
Organization Name:ABERDEEN PHYSICAL THERPY, LLC
Other - Org Name:DME & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-740-2045
Mailing Address - Street 1:8198 SOUTH JOG ROAD
Mailing Address - Street 2:SUITE #207
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472
Mailing Address - Country:US
Mailing Address - Phone:561-740-2045
Mailing Address - Fax:561-720-2414
Practice Address - Street 1:8198 SOUTH JOG ROAD
Practice Address - Street 2:SUITE #207
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472
Practice Address - Country:US
Practice Address - Phone:561-740-2045
Practice Address - Fax:561-720-2414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 3635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6696980OtherGHI PROVIDER NUMBER
FLY913AOtherBCBS PROVIDER NUMBER
FL7837593OtherAETNA PROVIDER NUMBER
FL6696980OtherGHI PROVIDER NUMBER