Provider Demographics
NPI:1972548022
Name:FLORIDA THERAPY SERVICES INC
Entity Type:Organization
Organization Name:FLORIDA THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROLLIN
Authorized Official - Last Name:CABLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-769-6001
Mailing Address - Street 1:2711 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-1366
Mailing Address - Country:US
Mailing Address - Phone:850-769-6001
Mailing Address - Fax:850-769-6003
Practice Address - Street 1:2711 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-1366
Practice Address - Country:US
Practice Address - Phone:850-769-6001
Practice Address - Fax:850-769-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075858203Medicaid
FL075858204Medicaid
FL075858205Medicaid
FL075858208Medicaid
FL075858209Medicaid
FL913786601Medicaid
FL913786602Medicaid
FL913786603Medicaid
FL913786605Medicaid
FL075858207Medicaid
FL175858202Medicaid
FL600013584Medicaid
FL913786604Medicaid
FL075858202Medicaid
FL075858206Medicaid
FL600013575Medicaid
GA600013581Medicaid
FL075858200Medicaid
FL600007582Medicaid
FL913786600Medicaid
FL600013584Medicaid
FL913786601Medicaid