Provider Demographics
NPI:1891889838
Name:ALL PERFORMANCE PHYSICAL THERAPY, PLC
Entity Type:Organization
Organization Name:ALL PERFORMANCE PHYSICAL THERAPY, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:BURNARD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:727-381-3600
Mailing Address - Street 1:2600 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-3123
Mailing Address - Country:US
Mailing Address - Phone:727-381-3600
Mailing Address - Fax:727-343-6277
Practice Address - Street 1:2600 66TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-3123
Practice Address - Country:US
Practice Address - Phone:727-381-3600
Practice Address - Fax:727-343-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0450ZMedicare ID - Type Unspecified