Functional Movement Rehab and Fitness, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT17788 Issued in FL

Legal business name

FUNCTIONAL MOVEMENT REHAB AND FITNESS, INC.

Practice address

2459 Cardinal LN
Palm Beach Gardens, FL 33410-1223

Phone

(561) 723-8437

NPI assigned

Oct 30, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Terra Yaskin, M.OTR/L

Title

Vice President

Phone

(561) 723-8437

Specialties & licenses 5

Addresses

Other identifiers 2

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1083968929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2459 CARDINAL LN",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334101223",
            "telephone_number": "561-723-8437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2459 CARDINAL LN",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334101223",
            "telephone_number": "561-723-8437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL MOVEMENT REHAB AND FITNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "YASKIN",
        "authorized_official_first_name": "TERRA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "561-723-8437",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT17788",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "FL",
            "license": "PT17788",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT17788",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT9985",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "FL",
            "license": "1061101186",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BN755Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "EN537Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.