Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Country Club PT PA

Organization Geriatric Physical Therapist · NPI 1578928420

Country Club PT PA provides Geriatric Physical Therapist services 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 Not confirmed with CMS for 10 years — call before visiting
Phone: (941) 451-6689
Show map & directions

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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