Agewell South Physical Therapy and Wellness PA

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PT 26314 Issued in FL

Legal business name

AGEWELL SOUTH PHYSICAL THERAPY AND WELLNESS PA

Doing business as

Agewell South

Practice address

5180 W Atlantic Ave
Delray Beach, FL 33484-8103

Phone

(914) 318-1304

NPI assigned

Apr 4, 2011

Last updated

Feb 16, 2012By 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 Dragan, PT

Title

Co-Owner

Phone

(914) 318-1304

Specialties & licenses 1

Addresses

Other names 1

• Agewell South Doing business as

Locations

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1902195506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 RIDGE RD",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631308",
            "telephone_number": "914-318-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5180 W ATLANTIC AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848103",
            "telephone_number": "914-318-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGEWELL SOUTH PHYSICAL THERAPY AND WELLNESS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-04",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "DRAGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "914-318-1304",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "FL",
            "license": "PT 26314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agewell South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Geriatric Physical Therapist in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Geriatric Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.