Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Country Club PT PA

Organization Geriatric Physical Therapist · NPI 1578928420

Country Club PT PA is a Geriatric Physical Therapist in Venice, Florida. Licensed in Florida. Registered with an NPI since 2015.

Licensed in
FL
In the registry since
2015
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1331 Whispering Ln
Venice, FL 34285-6449
Phone: (941) 451-6689
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Physical Therapist (primary) Taxonomy 2251G0304X · Licence PT21464 (FL)

Record details

NPI number1578928420
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Corn — Office Manager · (941) 451-6689
NPI enumeratedDecember 19, 2015
Last updated in NPPESDecember 19, 2015
Mailing address1331 Whispering Ln, Venice, FL 34285-6449

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