Provider Demographics
NPI:1356611545
Name:MEDICAL THERAPY SERVICE, INC.
Entity type:Organization
Organization Name:MEDICAL THERAPY SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALYE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:813-516-4120
Mailing Address - Street 1:3501 W VINE ST
Mailing Address - Street 2:STE. 316
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4643
Mailing Address - Country:US
Mailing Address - Phone:407-201-5306
Mailing Address - Fax:
Practice Address - Street 1:3501 W VINE ST
Practice Address - Street 2:STE. 316
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4643
Practice Address - Country:US
Practice Address - Phone:407-201-5306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy