Organization Active NPI

Physiotherapy Plus Inc

Doing business as Fyzical Therapy & Balance Centers of Orlando (Fyzical West Orlando)

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1508817537
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 21887 Issued in FL
Legal business name
PHYSIOTHERAPY PLUS INC
Doing business as
Fyzical Therapy & Balance Centers of Orlando (Fyzical West Orlando)
Practice address
6388 Silver Star Rd Ste 1E
Orlando, FL 32818-3235
Phone
(321) 369-9133
Fax
(888) 696-1020
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Authorized official

Name
Idler Bonhomme, LMT, MPT, DPTNPI 1427008556
Title
Clinical Dir
Phone
(321) 369-9133

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: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT 21887 FL Primary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X MA 32752 FL

Addresses

Primary practice location

6388 Silver Star Rd Ste 1E
Orlando, FL 32818-3235

Mailing address

6388 Silver Star Rd
1E
Orlando, FL 32818-3235
Phone (321) 369-9133

Other identifiers 3

IdentifierTypeStateIssuer
100816700MedicaidFL
017686500MedicaidFL
891208400MedicaidFL

Other names 1

  • Fyzical Therapy & Balance Centers of Orlando (Fyzical West Orlando) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070531000393 FL Part B Supplier - Clinic/Group Practice 7214938687 Receives reassigned benefits from 4 practitioners
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

1603 S Hiawassee Rd
Ste 105
Orlando, FL 32835
Phone (407) 293-2150

51 NW Carolina St
Ste 103
West Melbourne, FL 32904
Phone (321) 757-0626

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1508817537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6388 SILVER STAR RD",
            "address_2": "1E",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183235",
            "telephone_number": "321-369-9133",
            "fax_number": "888-696-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6388 SILVER STAR RD STE 1E",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183235",
            "telephone_number": "321-369-9133",
            "fax_number": "888-696-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOTHERAPY PLUS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "BONHOMME",
        "authorized_official_first_name": "IDLER",
        "authorized_official_title_or_position": "CLINICAL DIR",
        "authorized_official_telephone_number": "321-369-9133",
        "authorized_official_credential": "LMT, MPT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 21887",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA 32752",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100816700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017686500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891208400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Therapy & Balance Centers of Orlando (Fyzical West Orlando)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.