Provider Demographics
NPI:1730625971
Name:VORA, HARSHAL (DPT)
Entity type:Individual
Prefix:
First Name:HARSHAL
Middle Name:
Last Name:VORA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 SE GOLDTREE DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7582
Mailing Address - Country:US
Mailing Address - Phone:772-335-7966
Mailing Address - Fax:
Practice Address - Street 1:1400 SE GOLDTREE DR STE 205
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7583
Practice Address - Country:US
Practice Address - Phone:772-335-7966
Practice Address - Fax:772-335-7963
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018072225100000X
FLPT32266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist