Broward Manual Rehab Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 19201 Issued in FL

Legal business name

BROWARD MANUAL REHAB INC

Practice address

4959 N State Road 7
Ste D
Tamarac, FL 33319-5871

Phone

(954) 717-1983

Fax

(954) 717-1984

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Dimitri Cosmios, P.T.

Title

President

Phone

(954) 717-1983

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710106190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4959 N STATE ROAD 7",
            "address_2": "STE D",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333195871",
            "telephone_number": "954-717-1983",
            "fax_number": "954-717-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 N STATE ROAD 7",
            "address_2": "STE D",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333195871",
            "telephone_number": "954-717-1983",
            "fax_number": "954-717-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD MANUAL REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COSMIOS",
        "authorized_official_first_name": "DIMITRI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-717-1983",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 19201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Tamarac, FL
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• 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.