Organization
FLORIDA WEST COAST PHYSICAL THERAPY & REHABILITATION CENTER INC
Active
Other names
Florida West Coast Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG B MILLER P.T. (OWNER ADMINISTRATOR)
(941) 484-1939
Entity
Organization
Contact information
Practice address
256 NOKOMIS AVE S, SUITE 2, VENICE, FL 34285-2357
(941) 484-1939
(941) 484-7804
Mailing address
256 NOKOMIS AVE S, SUITE 2, VENICE, FL 34285-2357
(941) 484-1939
(941) 484-7804
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
261QP2000X
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0560932
AETNA
FL
01
—
154014858
TRICARE
SC
Enumeration date
02/04/2007
Last updated
06/20/2008
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