NPIMap

Organization Active NPI

Free Motion Physical Therapy of Brevard PA

  • Physical Therapist
  • Rockledge, FL
National Provider Identifier
1467624874
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FREE MOTION PHYSICAL THERAPY OF BREVARD PA
Practice address
1982 Rockledge Blvd Ste 102
Rockledge, FL 32955-3723
Phone
(321) 631-5366
Fax
(321) 631-5365
NPI assigned
Mar 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Authorized official

Name
Anthony Robert Razzino, MSPTNPI 1396839387
Title
Clinical Director/Owner
Phone
(321) 242-7575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X OT231 FL

Addresses

Primary practice location

1982 Rockledge Blvd Ste 102
Rockledge, FL 32955-3723

Mailing address

1300 Bedford Dr Ste 105
Melbourne, FL 32940-1991
Phone (321) 242-7575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050914000603 FL Part B Supplier - Clinic/Group Practice 1456384031 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Rockledge, FL; Melbourne, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Free Motion Physical Therapy of Brevard PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1300 Bedford Dr
Ste 105
Melbourne, FL 32940
Phone (321) 242-7575

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1467624874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BEDFORD DR STE 105",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401991",
            "telephone_number": "321-242-7575",
            "fax_number": "321-242-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1982 ROCKLEDGE BLVD STE 102",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553723",
            "telephone_number": "321-631-5366",
            "fax_number": "321-631-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREE MOTION PHYSICAL THERAPY OF BREVARD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "RAZZINO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "321-242-7575",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "FL",
            "license": "OT231",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.