Florida Gulfcoast Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

0603462 Issued in FL

Legal business name

FLORIDA GULFCOAST PHYSICAL THERAPY LLC

Practice address

10011 Estero Town Commons PL
Suite 101a
Estero, FL 33928

Phone

(239) 948-2222

Fax

(239) 948-2225

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Glen Franklin Metrick, PHYSICAL THERAPIST

Title

Cooperating Manager

Phone

(239) 948-2222

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1992890693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10011 ESTERO TOWN COMMONS PL",
            "address_2": "SUITE 101A",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339289465",
            "telephone_number": "239-948-2222",
            "fax_number": "239-948-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10011 ESTERO TOWN COMMONS PL",
            "address_2": "SUITE 101A",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "33928",
            "telephone_number": "239-948-2222",
            "fax_number": "239-948-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA GULFCOAST PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "METRICK",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "COOPERATING MANAGER",
        "authorized_official_telephone_number": "239-948-2222",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "0603462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Estero, FL
• Providers in Estero, 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 Apr 26, 2011; 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.