Physical Therapy & Sports Rehab LLC

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

PT21702 Issued in FL

Legal business name

PHYSICAL THERAPY & SPORTS REHAB LLC

Practice address

1290 Old Congress Ave.
West Palm Beach, FL 33409

Phone

(561) 312-1120

Fax

(954) 622-9120

NPI assigned

Mar 8, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Richard Henry Hoffman

Title

Vice President

Phone

(561) 312-1120

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1538433552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 OLD CONGRESS AVE.",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33409",
            "telephone_number": "561-312-1120",
            "fax_number": "954-622-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 OLD CONGRESS AVE.",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33409",
            "telephone_number": "561-312-1120",
            "fax_number": "954-622-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY & SPORTS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "561-312-1120",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "FL",
            "license": "PT21702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "DF544Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix Diagnostics, LLC
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• Phoenix Pro Management, Inc
• Phyllis Duncombe Childcare and Family Resource Center Inc
• Physical Medicine & Rehab Center of Florida, LLC
• Physical Therapy Institute and Aquatic Rehab, Inc
• Physical Therapy Institute and Aquatic Rehab, Inc
• Physical Therapy Now of Mangonia Park
• Physical Therapy Specialties Inc
• Physicians Care Management

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.