Provider Demographics
NPI:1679299945
Name:PUNTA GORDA FAMILY PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:PUNTA GORDA FAMILY PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:NAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-548-6131
Mailing Address - Street 1:3400 COLONY CT
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-7042
Mailing Address - Country:US
Mailing Address - Phone:941-548-6131
Mailing Address - Fax:941-347-8120
Practice Address - Street 1:3400 COLONY CT
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-7042
Practice Address - Country:US
Practice Address - Phone:941-548-6131
Practice Address - Fax:941-347-8120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy