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Organization
PALM HARBOR PHYSICAL THERAPY
Active
Organization
PALM HARBOR PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW N LOSCALZO PT, DPT, ATC (ADMINISTRATOR)
(727) 789-6008
Entity
Organization
Contact information
Practice address
30522 US HIGHWAY 19 N, SUITE 110, PALM HARBOR, FL 34684-4444
(727) 789-6008
(727) 789-0716
Mailing address
30522 US HIGHWAY 19 N, SUITE 110, PALM HARBOR, FL 34684-4444
(727) 789-6008
(727) 789-0716
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4811
FL
235Z00000X
Speech-Language Pathologist
SA2119
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
882119400
—
FL
01
—
R3L
B/C B/S PROV# - PH OFFICE
FL
01
—
RA4
BCBS PROV# - NPR OFFICE
FL
Enumeration date
07/21/2005
Last updated
03/20/2013
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