Provider Demographics
NPI:1952598617
Name:FIRST OPTION PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:FIRST OPTION PHYSICAL THERAPY INC
Other - Org Name:BAYTEX OF FLORIDA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HELBERTS
Authorized Official - Middle Name:C
Authorized Official - Last Name:TAMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-486-8126
Mailing Address - Street 1:200 CAPRI ISLES BLVD UNIT 1C
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-2335
Mailing Address - Country:US
Mailing Address - Phone:941-486-8126
Mailing Address - Fax:941-412-3599
Practice Address - Street 1:200 CAPRI ISLES BLVD UNIT 1C
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292
Practice Address - Country:US
Practice Address - Phone:941-486-8126
Practice Address - Fax:941-412-3599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6775225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY6366OtherBLUE CROSS BLUE SHIELD
FL0006775OtherPT LICENSE
FL0006775OtherPT LICENSE
FLAT176Medicare PIN