Organization
PRODIGY HEALTHCARE SPECIALISTS, INC.
Active
Other names
Prodigy Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RACHEL K RELAO RPT (PHYSICAL THERAPIST)
(941) 729-8600
Entity
Organization
Contact information
Practice address
2823 US HIGHWAY 301 N, STE. 4, ELLENTON, FL 34222-2084
(941) 729-8600
(941) 729-4440
Mailing address
2823 US HIGHWAY 301 N, STE. 4, ELLENTON, FL 34222-2084
(941) 729-8600
(941) 729-4440
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT11333
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y905G
BCBS OF FLORIDA
FL
Enumeration date
02/15/2007
Last updated
08/22/2020
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