Organization
PHI-THERAS REHAB LLC
Active
Organization
PHI-THERAS REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN SERRANO PT (PRESIDENT)
(941) 257-4763
Entity
Organization
Contact information
Practice address
12450 TAMIAMI TRL S, SUITE E, NORTH PORT, FL 34287-1473
(941) 257-4763
(941) 257-4766
Mailing address
12450 TAMIAMI TRL S, SUITE E, NORTH PORT, FL 34287-1473
(941) 257-4763
(941) 257-4766
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT29353
FL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
PT29353
FL
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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