Provider Demographics
NPI:1336995935
Name:ASCEND PHYSIOTHERAPY & PERFORMANCE
Entity Type:Organization
Organization Name:ASCEND PHYSIOTHERAPY & PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-850-1079
Mailing Address - Street 1:807 NE 2ND AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-1978
Mailing Address - Country:US
Mailing Address - Phone:954-667-7424
Mailing Address - Fax:
Practice Address - Street 1:807 NE 2ND AVE STE 300
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-1978
Practice Address - Country:US
Practice Address - Phone:954-667-7424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty