Provider Demographics
NPI:1396150454
Name:RICKI S HANZEL DPT PA
Entity type:Organization
Organization Name:RICKI S HANZEL DPT PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:HANZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:954-804-8305
Mailing Address - Street 1:2721 OCEAN CLUB BLVD
Mailing Address - Street 2:APT. 106
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-3945
Mailing Address - Country:US
Mailing Address - Phone:954-804-8305
Mailing Address - Fax:
Practice Address - Street 1:3800 S OCEAN DR
Practice Address - Street 2:G3
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-2927
Practice Address - Country:US
Practice Address - Phone:954-367-5920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20752261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy