Provider Demographics
NPI:1952872368
Name:FLORIDA PHYSICAL THERAPY & OCCUPATIONAL THERAPY LLC
Entity Type:Organization
Organization Name:FLORIDA PHYSICAL THERAPY & OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHEKDON
Authorized Official - Middle Name:D
Authorized Official - Last Name:HIRSCHUBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-738-9129
Mailing Address - Street 1:1725 BELMONT CIR SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-6714
Mailing Address - Country:US
Mailing Address - Phone:608-738-9129
Mailing Address - Fax:
Practice Address - Street 1:1725 BELMONT CIR SW
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968-6714
Practice Address - Country:US
Practice Address - Phone:608-738-9129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Single Specialty