Provider Demographics
NPI:1750675922
Name:PHYSICAL THERAPEUTIC SERVICES CORP
Entity type:Organization
Organization Name:PHYSICAL THERAPEUTIC SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PERNETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:3053-382-6889
Mailing Address - Street 1:5881 NW 151ST ST
Mailing Address - Street 2:SUITE 127
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2450
Mailing Address - Country:US
Mailing Address - Phone:305-338-2689
Mailing Address - Fax:305-675-2668
Practice Address - Street 1:5881 NW 151ST ST
Practice Address - Street 2:SUITE 127
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2450
Practice Address - Country:US
Practice Address - Phone:305-338-2689
Practice Address - Fax:305-675-2668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy