Phi-Theras Rehab LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT29353 Issued in FL

Legal business name

PHI-THERAS REHAB LLC

Practice address

12450 Tamiami TRL S
Suite E
North Port, FL 34287-1473

Phone

(941) 257-4763

Fax

(941) 257-4766

NPI assigned

Nov 3, 2016

Last updated

Nov 3, 2016By 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

Jordan Serrano, PT

Title

President

Phone

(941) 257-4763

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1366994519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 TAMIAMI TRL S",
            "address_2": "SUITE E",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342871473",
            "telephone_number": "941-257-4763",
            "fax_number": "941-257-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 TAMIAMI TRL S",
            "address_2": "SUITE E",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342871473",
            "telephone_number": "941-257-4763",
            "fax_number": "941-257-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHI-THERAS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "SERRANO",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-257-4763",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PT29353",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "FL",
            "license": "PT29353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Frank Carmen Pettinato II, DMD, MS
• Nicholas Petty, PHARMD
• Phase1 Mobile PT
• Philippe Noel MD and Anna Berenstein MD PA
• Physical Therapy Options Inc
• Physioworks Inc
• Pieces of a Dream Counseling Center (North Port Community Church of God In Christ)
• Tatum Pierce

• Physical Medicine & Rehabilitation Physician in North Port, FL
• Providers in North Port, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.