Provider Demographics
NPI:1952321762
Name:SUPERIOR CARE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:SUPERIOR CARE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SELIG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-276-3646
Mailing Address - Street 1:100 E LINTON BLVD
Mailing Address - Street 2:SUITE #407B
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-3327
Mailing Address - Country:US
Mailing Address - Phone:561-276-3646
Mailing Address - Fax:561-276-3648
Practice Address - Street 1:100 E LINTON BLVD
Practice Address - Street 2:SUITE #407B
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3327
Practice Address - Country:US
Practice Address - Phone:561-276-3646
Practice Address - Fax:561-276-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12029261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4334Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
FLY8005AMedicare ID - Type UnspecifiedINDIVIDUAL THERAPIST MC #