Provider Demographics
NPI:1982752192
Name:SENIOR FIRST PHYSICAL THERAPY CORP
Entity Type:Organization
Organization Name:SENIOR FIRST PHYSICAL THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TEMISTOCLES
Authorized Official - Middle Name:RUBEN
Authorized Official - Last Name:POZO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-236-4523
Mailing Address - Street 1:6508 BLUE BAY CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7219
Mailing Address - Country:US
Mailing Address - Phone:561-236-4523
Mailing Address - Fax:561-478-9349
Practice Address - Street 1:6508 BLUE BAY CIR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-7219
Practice Address - Country:US
Practice Address - Phone:561-236-4523
Practice Address - Fax:561-478-9349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4482OtherMEDICARE
FLK4482Medicare PIN