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Contact Information

COUNTRY CLUB PT PA
1331 WHISPERING LN
VENICE, FL34285-6449
 Phone: 941-451-6689
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for COUNTRY CLUB PT PA

NPI # 1578928420
LBN Legal business name COUNTRY CLUB PT PA
Authorized official LISA CORN - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/19/2015
Last updated 12/19/2015 - About 10 years ago
Identifiers
FL License # PT21464
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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