Personal Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 8870 Issued in FL

Legal business name

PERSONAL PHYSICAL THERAPY, INC.

Practice address

839 NW 98TH Ave
Plantation, FL 33324-6129

Phone

(954) 599-8359

Fax

(954) 370-8291

NPI assigned

Sep 15, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dwight A Quallo, RPT

Title

President

Phone

(954) 599-8359

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043205925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 NW 98TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333246129",
            "telephone_number": "954-599-8359",
            "fax_number": "954-370-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 NW 98TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333246129",
            "telephone_number": "954-599-8359",
            "fax_number": "954-370-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "QUALLO",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-599-8359",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 8870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.