Sportsedge Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SPORTSEDGE PHYSICAL THERAPY, LLC

Practice address

4800 NE 20TH Ter Ste 303
Fort Lauderdale, FL 33308-4510

Phone

(954) 771-8177

NPI assigned

Nov 21, 2019

Organization subpart

No

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

Authorized official

Name

Gernell Hamilton

Title

Credentialing Specialist

Phone

(954) 451-3008

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Sportsedge Physical Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sportsedge Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Margate, FL
  • NPI 1407492424
  NPD tax ID

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1952947285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11147",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333391147",
            "telephone_number": "954-451-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 NE 20TH TER STE 303",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084510",
            "telephone_number": "954-771-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTSEDGE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "GERNELL",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "954-451-3008"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "261QP2000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Spira, M.D.
• Spiritual Pyschiatry PC
• Jossette Spitaletto, LMHC
• Imani Spivey
• Khrystyna Splavnyk, PA
• Jane Marie Squillante, LCSW
• SRB Counseling & Consulting PLLC
• Rajkumar Sreekumar, CLINICAL PHARMACIST
• St Annes Care Agency Inc
• Stephanie St Fleur

• Physical Therapy Clinic/Center in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.