PHYSICAL THERAPY WELLNESS GROUP NPI 1023677630

NPI Information

  • NPI: 1023677630
  • Provider Name: PHYSICAL THERAPY WELLNESS GROUP
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 519 SW NAGLE PLACE
    PORT SAINT LUCIE, FL
    ZIP 34953
  • Phone: (772) 209-1183

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NPI Details

PHYSICAL THERAPY WELLNESS GROUP is a clinic center in Port Saint Lucie, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PHYSICAL THERAPY WELLNESS GROUP NPI is 1023677630. The provider is registered as an organization entity type.

The provider's business location address is:

519 SW NAGLE PLACE
PORT SAINT LUCIE, FL
ZIP 34953
Phone: (772) 209-1183

The provider's authorized official is Sperancia Anna White .
The authorized official title is Physical Therapist/owner and has the following contact phone number (772) 209-1183.

The enumeration date for this NPI number is 6/7/2019 and was last updated on 5/23/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1261Q00000XMEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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