Provider Demographics
NPI:1770131443
Name:FYZICAL THERAPY & BALANCE CENTER ROCKLEDGE-VIERA
Entity type:Organization
Organization Name:FYZICAL THERAPY & BALANCE CENTER ROCKLEDGE-VIERA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PT, AUTHORIZED OFFICAL
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BREMER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:321-351-2700
Mailing Address - Street 1:634 BARNES BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5217
Mailing Address - Country:US
Mailing Address - Phone:321-351-2700
Mailing Address - Fax:321-351-2727
Practice Address - Street 1:634 BARNES BOULEVARD
Practice Address - Street 2:UNIT 202
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955
Practice Address - Country:US
Practice Address - Phone:321-351-2700
Practice Address - Fax:321-351-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy