Functional Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 21146 Issued in FL

Legal business name

FUNCTIONAL PHYSICAL THERAPY

Doing business as

Bridge of Hope

Practice address

1300 Kevstin Dr
Kissimmee, FL 34744-5843

Phone

(407) 575-4636

Fax

(321) 250-7425

NPI assigned

Jan 22, 2014

Last updated

Jan 22, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

FUNCTIONAL PHYSICAL THERAPYAs reported in NPPES

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

Authorized official

Name

Mr. Hector L Rodriguez, AD

Title

Administrator

Phone

(407) 575-4636

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bridge of Hope Doing business as

Tax ID family

Functional Physical Therapy2 organizations share this tax ID, including this one

Part of

Functional Physical Therapy

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bridge of Hope

  • Physical Therapist
  • Kissimmee, FL
  • NPI 1477983153
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Functional Physical Therapy, LLC

  • Physical Therapist
  • Champions Gate, FL
  • NPI 1649598491
  NPPES parent name

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1437572781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452878",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347452878",
            "telephone_number": "407-575-4636",
            "fax_number": "321-250-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 KEVSTIN DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445843",
            "telephone_number": "407-575-4636",
            "fax_number": "321-250-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL PHYSICAL THERAPY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FUNCTIONAL PHYSICAL THERAPY",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-575-4636",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "AD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 21146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPY GROUP",
            "identifier": "K9635A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridge of Hope",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Ivette Fuentes Caraballo
• Argeny Fuentes
• Victoria R Fuentes
• Chiara Fuller, LCSW
• Lawrence P Fuller, OD
• Fundacion Hablando de Mujer a Mujer, Inc
• Isis Funez
• Jessica Fuoss, LMHC
• Nicholas Fusco
• FWC Perinatal, LLC

• Physical Therapist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.