Organization
PRIME PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN LYNN JOHNSON LMT (OWNER)
(813) 932-3315
Entity
Organization
Contact information
Practice address
7815 N DALE MABRY HWY, SUITE 102, TAMPA, FL 33614-3203
(813) 932-3315
(813) 935-9835
Mailing address
PO BOX 272689, TAMPA, FL 33688-2689
(813) 932-3315
(813) 935-9835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18611
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222534
—
FL
01
—
2906996
CIGNA
FL
01
—
3041824
AETNA HMO
FL
01
—
7822407
AETNA PPO
FL
01
—
Y0571
BCBS
FL
Enumeration date
04/23/2007
Last updated
08/22/2020
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