Starace Total Balance Physical Therapy P.a.
Organization Active NPI Physical Therapist · Bunnell, FL
NPI 1043750276 · NPPES record last updated Jun 6, 2024
Key facts
- NPI
- 1043750276
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT28234 (FL)
- Legal business name
- STARACE TOTAL BALANCE PHYSICAL THERAPY P.A.
- Practice address
- 2550 N State St Unit 4
Bunnell, FL 32110-3418 - Phone
- (386) 385-8749
- Fax
- (386) 693-1798
- NPI assigned
- Mar 7, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Michael Brandon Starace, DPT
- Title
- Doctorofphysicaltherapy/President
- Phone
- (732) 668-4988
Practitioners 2
-
Stephen T. Davis, P.T.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171220000804 | FL | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 1557621463 |
Receives reassigned benefits from 2 practitioners Practice locations: Bunnell, FL |
National Provider Directory
Locations
2550 N State St
Bunnell, FL 32110
2550 N State St
Unit 4
Bunnell, FL 32110
Phone (386) 385-8749
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | PT28234 | FL | Yes |
Addresses
Primary practice location
2550 N State St Unit 4
Bunnell, FL 32110-3418
Mailing address
32 Bannbury LN
Palm Coast, FL 32137-8848
Phone (732) 668-4988
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689006744 | Other | FL | INDIVIDUAL NPI |
Other providers in Bunnell, FL
- Sma Healthcare Inc
- Sma Healthcare Inc
- Sma Healthcare Inc
- Sma Healthcare Inc
- Sma Healthcare Inc
- Michael Brandon Starace
- State of Florida Deparment of Health
- State of Florida Department of Health
- State of Florida Department of Health
- State of Florida Department of Health
All providers in Bunnell, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.