Provider Demographics
NPI:1801064761
Name:BETTER BODY PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:BETTER BODY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:DANIELS
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:352-694-6466
Mailing Address - Street 1:821 NE 36TH TER
Mailing Address - Street 2:SUITE #8
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-2049
Mailing Address - Country:US
Mailing Address - Phone:352-694-6466
Mailing Address - Fax:352-694-3657
Practice Address - Street 1:9401 SW STATE ROAD 200
Practice Address - Street 2:BLDG. 2000, SUITE 2001
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481
Practice Address - Country:US
Practice Address - Phone:352-854-4017
Practice Address - Fax:352-854-4389
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETTER BODY PHYSICAL THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-13
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT3979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3137Medicare PIN