Provider Demographics
NPI:1649524018
Name:SAYLOR PHYSICAL THERAPY OF PALM BEACH GARDENS LLC
Entity type:Organization
Organization Name:SAYLOR PHYSICAL THERAPY OF PALM BEACH GARDENS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-832-5383
Mailing Address - Street 1:8845 N MILITARY TRL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6298
Mailing Address - Country:US
Mailing Address - Phone:561-223-3872
Mailing Address - Fax:561-223-3895
Practice Address - Street 1:300 AVENUE OF CHAMPIONS STE 100
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33418-3615
Practice Address - Country:US
Practice Address - Phone:561-223-3872
Practice Address - Fax:561-223-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL12000140649302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization