Provider Demographics
NPI:1851072466
Name:FLORIDA GOLF PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:FLORIDA GOLF PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:BURHOE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:941-999-1129
Mailing Address - Street 1:203 BAYTREE DR
Mailing Address - Street 2:
Mailing Address - City:ROTONDA WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33947-3821
Mailing Address - Country:US
Mailing Address - Phone:941-999-1129
Mailing Address - Fax:
Practice Address - Street 1:203 BAYTREE DR
Practice Address - Street 2:
Practice Address - City:ROTONDA WEST
Practice Address - State:FL
Practice Address - Zip Code:33947-3821
Practice Address - Country:US
Practice Address - Phone:941-999-1129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty