TIDELINE SPORTS PERFORMANCE & REHABILITATION LLC (NPI# 1255930855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255930855 |
| Entity Type | Organization |
| Organization Name | TIDELINE SPORTS PERFORMANCE & REHABILITATION LLC |
| Practice Address |
5261 Paylor Ln Lakewood Ranch FL 34240-2203 |
| Mailing Address |
13947 Siena Loop Lakewood Ranch FL 34202-2446 |
| Practice Telephone | 9419613402 |
| Mailing Telephone | 9412180551 |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2020-10-23 |
| Authorized Official Name | MICHAEL SCLAFANI (OWNER) |
| Authorized Official Telephone | 9412180551 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CLEVELAND CLINIC FLORIDA | 1962828889 | 01 |
| Street Address |
5261 PAYLOR LN |
| City | LAKEWOOD RANCH |
| State | FL |
| Zip Code | 34240-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548879794 | Vascular Specialist of Venice and Sarasota Pl | Radiology | 6600 University Parkway, #102, Sarasota, FL 34240 | 2020-07-23 |
| 1659918704 | Jessie Lee Mcgath | Behavior Technician | 8425 Vicela Drive, Sarasota, FL 34240 | 2019-12-09 |
| 1841847217 | Susan Lorraine Sell | Occupational Therapy Assistant | Sensory Solutions LLC, 22 Sarasota Center Blvd, Sarasota, FL 34240 | 2019-08-21 |
| 1366912990 | Mary Cecelia Prado | Behavior Technician | 6976 Professional Parkway, Lakewood Ranch, FL 34240 | 2018-11-27 |
| 1841783172 | Rachel M Sproha | Behavior Technician | 8259 Vicela Dr, Sarasota, FL 34240 | 2018-06-12 |
| 1942792767 | Performance Acupuncture | Acupuncturist | 5212 Paylor Ln, Sarasota, FL 34240 | 2018-06-06 |
| 1194125773 | Magnolia Dialysis LLC | Clinic/Center | 6960 Professional Pkwy E, Units 4 & 5, Sarasota, FL 34240 | 2014-09-02 |
| 1497164370 | Terrie Rierson | Speech-Language Pathologist | 63 Sarasota Center Blvd #101, Sarasota, FL 34240 | 2014-08-05 |
| 1982984134 | Angelheart LLC | Family Medicine | 3004 Seasons Boulivard, Sarasota, FL 34240 | 2011-08-19 |
| 1225259492 | Michael S Goren | Pharmacist | 775 Bell Road, Sarasota, FL 34240 | 2007-05-02 |
| Find all providers in zip 34240 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278493 | Confident Pt LLC | Clinic/Center | 6818 Tumbleweed Trl, Lakewood Ranch, FL 34202-1852 | 2019-01-07 |
| 1124474135 | Functional Performance | Clinic/Center | 12630 Rockrose Gln, Lakewood Ranch, FL 34202-2829 | 2016-05-09 |
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| 1356942742 | Restore Pelvic Health & Rehab LLC | Clinic/Center | 301 E Yamato Rd Ste 1240, Boca Raton, FL 33431-4931 | 2020-11-03 |
| 1558962019 | Ldg Medical Center LLC | Clinic/Center | 4485 Stirling Rd, Davie, FL 33314-7517 | 2020-11-02 |
| 1578162780 | Fourth Trimester Wellness LLC | Clinic/Center | 711 Chancellar Dr, Lutz, FL 33548-4512 | 2020-10-19 |
| 1306445754 | Concierge Rehab Inc | Clinic/Center | 1045 E Heritage Club Cir, Delray Beach, FL 33483-3483 | 2020-10-17 |
| 1689272627 | Ucdm Services Inc | Clinic/Center | 12030 Sw 129th Ct Ste 103, Miami, FL 33186-4584 | 2020-10-12 |
| 1902404163 | Frontline Physical Therapy | Clinic/Center | 8655 Bayou Way N, Pinellas Park, FL 33782-4549 | 2020-10-11 |
| 1891393138 | Venice Physical Therapy and Sports Medicine | Clinic/Center | 1776 S Tamiami Trl, Venice, FL 34293-1602 | 2020-10-09 |
| 1750988812 | Angeles Medical Center,inc. | Clinic/Center | 8725 Nw 18th Ter Ste 403, Doral, FL 33172-2610 | 2020-10-02 |
| 1740887967 | Neuro Thrive LLC | Clinic/Center | 1963 Ne Felicita Pl, Jensen Beach, FL 34957-5756 | 2020-10-01 |
| 1487261400 | Zyam Wellness LLC | Clinic/Center | 8249 Nw 36th St Ste 103, Doral, FL 33166-6673 | 2020-09-24 |
| Find all providers with the same taxonomy | ||||
| City | LAKEWOOD RANCH |
| Zip Code | 34240 |
Please comment or provide details below to improve the information on TIDELINE SPORTS PERFORMANCE & REHABILITATION LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.