Physical Therapy Wellness Group | |
519 Sw Nagle Place Port Saint Lucie FL 34953 | |
(772) 209-1183 | |
Not Available |
Full Name | Physical Therapy Wellness Group |
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Speciality | Clinic/Center |
Location | 519 Sw Nagle Place, Port Saint Lucie, Florida |
Authorized Official Name and Position | Sperancia Anna White (PHYSICAL THERAPIST/OWNER) |
Authorized Official Contact | 7722091183 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Physical Therapy Wellness Group 10380 Sw Village Center Dr # 355 Port Saint Lucie FL 34987-1931 Ph: (772) 209-1183 | Physical Therapy Wellness Group 519 Sw Nagle Place Port Saint Lucie FL 34953 Ph: (772) 209-1183 |
NPI Number | 1023677630 |
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Provider Enumeration Date | 06/07/2019 |
Last Update Date | 05/23/2020 |
Medicare PECOS PAC ID | 7810314853 |
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Medicare Enrollment ID | O20200904000825 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023677630 | NPI | - | NPPES |
261Q00000X | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Sperancia Anna White |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1750602462 PECOS PAC ID: 4981636610 Enrollment ID: I20200904001680 |
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