Provider Demographics
NPI:1205071925
Name:MY PT INC
Entity type:Organization
Organization Name:MY PT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REHABILITATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:NESSIM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:305-970-2809
Mailing Address - Street 1:19820 NE 19TH CT
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179
Mailing Address - Country:US
Mailing Address - Phone:305-970-2809
Mailing Address - Fax:305-705-1359
Practice Address - Street 1:19820 NE 19TH CT
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179
Practice Address - Country:US
Practice Address - Phone:305-970-2809
Practice Address - Fax:305-705-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT15782225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty