Avondale Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT8908 Issued in FL

Legal business name

AVONDALE PHYSICAL THERAPY, INC.

Practice address

12471 Sawgrass CT
Wellington, FL 33414-4822

Phone

(451) 753-7480

Fax

(561) 753-7972

NPI assigned

Jan 18, 2007

Last updated

Aug 17, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Eric Hagan, PTA

Title

President

Phone

(561) 346-8508

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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.

• Christine Lynn Cline, PT

  • Physical Therapist
  • Wellington, FL
  • NPI 1336331800
  Medicare reassignment NPD

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1861544603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12471 SAWGRASS CT",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144822",
            "telephone_number": "451-753-7480",
            "fax_number": "561-753-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12471 SAWGRASS CT",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144822",
            "telephone_number": "451-753-7480",
            "fax_number": "561-753-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVONDALE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "HAGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-346-8508",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT8908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Wellington, FL
• Providers in Wellington, 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 17, 2007; 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.