Provider Demographics
NPI:1043894207
Name:FLORIDIAN PHYSICAL THERAPY & BALANCE
Entity type:Organization
Organization Name:FLORIDIAN PHYSICAL THERAPY & BALANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHERRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-888-0796
Mailing Address - Street 1:PO BOX 150441
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33915-0441
Mailing Address - Country:US
Mailing Address - Phone:707-245-8065
Mailing Address - Fax:239-599-4377
Practice Address - Street 1:1519 SE 21ST ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-4657
Practice Address - Country:US
Practice Address - Phone:707-245-8065
Practice Address - Fax:239-599-4377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy