Provider Demographics
NPI:1144337452
Name:PERFORMANCE PHYSICAL THERAPY OF NAPLES
Entity type:Organization
Organization Name:PERFORMANCE PHYSICAL THERAPY OF NAPLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING/ BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YUSI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-692-9679
Mailing Address - Street 1:4949 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3027
Mailing Address - Country:US
Mailing Address - Phone:239-643-2040
Mailing Address - Fax:239-643-2080
Practice Address - Street 1:1201 PIPER BLVD STE 18
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1385
Practice Address - Country:US
Practice Address - Phone:239-593-3010
Practice Address - Fax:239-593-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7021225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID