Provider Demographics
NPI:1134273048
Name:KINETIX PHYSICAL THERAPY P A
Entity type:Organization
Organization Name:KINETIX PHYSICAL THERAPY P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CERE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MTC
Authorized Official - Phone:352-505-6665
Mailing Address - Street 1:2783 SW 87TH DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-9370
Mailing Address - Country:US
Mailing Address - Phone:352-505-6665
Mailing Address - Fax:352-226-8744
Practice Address - Street 1:2783 SW 87TH DR
Practice Address - Street 2:SUITE 102
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-9375
Practice Address - Country:US
Practice Address - Phone:352-505-6665
Practice Address - Fax:352-226-8744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty