Organization
OMEGA 40 SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE XYNIDIS R.P.T. (OWNER)
(386) 672-4080
Entity
Organization
Contact information
Practice address
1 S OLD KINGS RD, ORMOND BEACH, FL 32174-6177
(386) 672-4080
(386) 672-6197
Mailing address
1 S OLD KINGS RD, ORMOND BEACH, FL 32174-6177
(386) 672-4080
(386) 672-6197
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT0000766
FL
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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