Antonio Cruz
Individual provider Active NPI Physical Therapy Assistant · WPB, FL
NPI 1689061996 · NPPES record last updated Apr 24, 2015
Key facts
- NPI
- 1689061996
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA19014 (FL)
- Practice address
- 2939 S Haverhill Road
WPB, FL 33415 - Phone
- (561) 641-3130
- Fax
- (561) 964-6178
- NPI assigned
- Apr 24, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA19014 | FL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA19014 | FL | Yes |
Addresses
Primary practice location
2939 S Haverhill Road
WPB, FL 33415
Mailing address
7936 Ambleside Way
Lake Worth, FL 33467
Other providers in WPB, FL
All providers in WPB, FL · Physical Therapy Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.