Glades Physical Therapy and Sports Medicine

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT19361 Issued in FL

Legal business name

GLADES PHYSICAL THERAPY AND SPORTS MEDICINE

Practice address

1100 S Main St
Belle Glade, FL 33430-4910

Phone

(954) 701-0528

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Anthony J. Bullen, MSPT

Title

President

Phone

(954) 701-0528

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679797872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S MAIN ST",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334304910",
            "telephone_number": "954-701-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S MAIN ST",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334304910",
            "telephone_number": "954-701-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADES PHYSICAL THERAPY AND SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BULLEN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-701-0528",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glades Eye Care Incorporated
• Glades Holding Group
• Glades Home Health Care Medical Center LLC
• Glades Imaging Center LLC
• Glades Imaging Center LLC
• Glades Primary Care LLC
• Jaqui Melody Glucksman, RN
• Debbie Simone Gordon, APRN-BC
• D'End Lynette Greer
• Taskin U Haque, M.D.

• Physical Therapist in Belle Glade, FL
• Providers in Belle Glade, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.