Provider Demographics
NPI:1003126269
Name:PHYSICAL THERAPY PLUS BY THE SEA LLC
Entity type:Organization
Organization Name:PHYSICAL THERAPY PLUS BY THE SEA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:D
Authorized Official - Last Name:ERASMUS
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:954-545-4922
Mailing Address - Street 1:4747 N OCEAN DR STE 261
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE BY THE SEA
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2956
Mailing Address - Country:US
Mailing Address - Phone:954-545-4922
Mailing Address - Fax:954-545-4923
Practice Address - Street 1:4747 N OCEAN DR STE 261
Practice Address - Street 2:
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308-2956
Practice Address - Country:US
Practice Address - Phone:954-545-4922
Practice Address - Fax:954-545-4923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA19828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT42863OtherPT
FLPTA19828OtherLICENSE
FLPT 17504OtherPT FL LICENSURE
FLPT38076OtherPT
FLPT10772OtherLICENSE
FLPT24520OtherPT
FLPT42863OtherPT
FLPT38054OtherPT FL LICENSE
FLPTA19828OtherLICENSE