Provider Demographics
NPI:1932122298
Name:VISSERS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:VISSERS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RENA
Authorized Official - Middle Name:PAREKH
Authorized Official - Last Name:BISSESSAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:407-903-9444
Mailing Address - Street 1:7601 DELLA DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819
Mailing Address - Country:US
Mailing Address - Phone:407-903-9444
Mailing Address - Fax:407-903-9445
Practice Address - Street 1:7601 DELLA DR
Practice Address - Street 2:SUITE 3
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-903-9444
Practice Address - Fax:407-903-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRR1OtherBCBS
FL686693Medicare ID - Type Unspecified