Basic Information
| Provider Information | |||||||||
| NPI: | 1306239967 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED PHYSICAL THERAPY OF CENTRAL FLORIDA, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1202 SW 17TH STREET #201-229 | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344714421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526933378 | ||||||||
| FaxNumber: | 8887589645 | ||||||||
| Practice Location | |||||||||
| Address1: | 11962 COUNTY ROAD 101 STE 104 | ||||||||
| Address2: | |||||||||
| City: | THE VILLAGES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321629336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526933378 | ||||||||
| FaxNumber: | 8887589645 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2015 | ||||||||
| LastUpdateDate: | 09/07/2017 | ||||||||
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| AuthorizedOfficialLastName: | HAMMOND | ||||||||
| AuthorizedOfficialFirstName: | LESTER | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3526933378 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.