Organization
TRUST ORTHOPEDIC AND SPORTS REHAB LLC
Active
Other names
Trust Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MINA MALAK KHALIL SHEHATA PT, DPT (OWNER)
(727) 953-3031
Entity
Organization
Contact information
Practice address
29251 US HIGHWAY 19 N, CLEARWATER, FL 33761-2102
(727) 953-3031
(727) 264-1542
Mailing address
29251 US HIGHWAY 19 N, CLEARWATER, FL 33761-2102
(727) 953-3031
(727) 264-1542
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32409
FLORIDA LICENSE
FL
Enumeration date
04/26/2021
Last updated
09/08/2021
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