Provider Demographics
NPI:1922112465
Name:AQUATIC & ORTHOPEDIC REHAB SPECIALISTS LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:AQUATIC & ORTHOPEDIC REHAB SPECIALISTS LIMITED PARTNERSHIP
Other - Org Name:HORIZON PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:1300 W SAM HOUSTON PKWY S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-2447
Mailing Address - Country:US
Mailing Address - Phone:713-297-7000
Mailing Address - Fax:713-297-7090
Practice Address - Street 1:311 E INDIANTOWN RD
Practice Address - Street 2:SUITE C-4
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5062
Practice Address - Country:US
Practice Address - Phone:561-575-4770
Practice Address - Fax:561-575-4522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106863Medicare Oscar/Certification