Provider Demographics
NPI:1205906880
Name:SPORTFIT REHAB & TRAINING
Entity type:Organization
Organization Name:SPORTFIT REHAB & TRAINING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEARNS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT, CSCS
Authorized Official - Phone:305-319-0073
Mailing Address - Street 1:2 S BISCAYNE BLVD
Mailing Address - Street 2:SUITE 0014
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131
Mailing Address - Country:US
Mailing Address - Phone:305-206-3787
Mailing Address - Fax:305-381-6294
Practice Address - Street 1:2 S. BISCAYNE BLVD
Practice Address - Street 2:SUITE 0014
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131
Practice Address - Country:US
Practice Address - Phone:305-319-0073
Practice Address - Fax:305-913-3141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT72912251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty