Provider Demographics
NPI:1851416390
Name:SEABREEZE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:SEABREEZE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINQUE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:727-384-4600
Mailing Address - Street 1:419 PASADENA AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-2101
Mailing Address - Country:US
Mailing Address - Phone:727-384-4600
Mailing Address - Fax:727-384-4601
Practice Address - Street 1:419 PASADENA AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-2101
Practice Address - Country:US
Practice Address - Phone:727-384-4600
Practice Address - Fax:727-384-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5258174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT5258OtherPT LICENSE NUMBER
FLK5206Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER