Provider Demographics
NPI:1912915521
Name:PREFERRED PHYSICAL THERAPY ASSOCIATES
Entity Type:Organization
Organization Name:PREFERRED PHYSICAL THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYEROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:954-360-7779
Mailing Address - Street 1:3994 W. HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEEFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442
Mailing Address - Country:US
Mailing Address - Phone:954-360-7779
Mailing Address - Fax:561-395-6995
Practice Address - Street 1:3994 W. HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEEFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442
Practice Address - Country:US
Practice Address - Phone:954-360-7779
Practice Address - Fax:561-395-6995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225X00000X, 235Z00000X, 261QR0400X, 332B00000X
FL261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686846Medicare Oscar/Certification
FL5745570001Medicare NSC