Provider Demographics
NPI:1528711603
Name:PENSACOLA PELVIC HEALTH, LLC
Entity type:Organization
Organization Name:PENSACOLA PELVIC HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:PAPIZZO
Authorized Official - Last Name:KERSH
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:559-816-6576
Mailing Address - Street 1:5512 PEACH DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32571-2774
Mailing Address - Country:US
Mailing Address - Phone:559-816-6576
Mailing Address - Fax:
Practice Address - Street 1:415 N TARRAGONA ST STE A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-3969
Practice Address - Country:US
Practice Address - Phone:559-816-6576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty