Provider Demographics
NPI:1962503466
Name:ALPHA PHYSICAL THERAPY & REHABILITATION, INC.
Entity Type:Organization
Organization Name:ALPHA PHYSICAL THERAPY & REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER -
Authorized Official - Prefix:MS
Authorized Official - First Name:SUNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:407-451-9766
Mailing Address - Street 1:3603 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8068
Mailing Address - Country:US
Mailing Address - Phone:407-451-9766
Mailing Address - Fax:561-638-8861
Practice Address - Street 1:5300 W ATLANTIC AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8165
Practice Address - Country:US
Practice Address - Phone:561-638-8821
Practice Address - Fax:561-638-8861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2003-12134225100000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4056Medicare ID - Type UnspecifiedTHERAPY SERVICES