Organization
ON THE HOP ORTHO SPORTS & AQUATIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVAN BORODIAK (OWNER)
(561) 719-2872
Entity
Organization
Contact information
Practice address
7171 N. UNIVERSITY DRIVE, SUITE 111, TAMARAC, FL 33321-2902
(954) 722-9992
(954) 597-7773
Mailing address
6032 NW 83RD TER, PARKLAND, FL 33067-5039
(561) 719-2872
(954) 597-7773
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/25/2019
Last updated
09/04/2019
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