Provider Demographics
NPI:1992361455
Name:DELRAY CARE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:DELRAY CARE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SERVELLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-803-7761
Mailing Address - Street 1:3375 BURNS RD STE 104
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4360
Mailing Address - Country:US
Mailing Address - Phone:561-803-7761
Mailing Address - Fax:561-803-7762
Practice Address - Street 1:2645 N FEDERAL HWY STE 240
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-6111
Practice Address - Country:US
Practice Address - Phone:561-562-8561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty