Provider Demographics
NPI:1982354205
Name:ELEVATE PHYSIO & WELLNESS LLC
Entity Type:Organization
Organization Name:ELEVATE PHYSIO & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:KWIATKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CLT
Authorized Official - Phone:305-807-9972
Mailing Address - Street 1:1830 N UNIVERSITY DR # 269
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4114
Mailing Address - Country:US
Mailing Address - Phone:305-306-4110
Mailing Address - Fax:754-900-5142
Practice Address - Street 1:1830 N UNIVERSITY DR # 269
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-4114
Practice Address - Country:US
Practice Address - Phone:305-306-4110
Practice Address - Fax:754-900-5142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty