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Pro Vita Physical Therapy LLC

Physical Therapy Clinic/Center in Crestview, FL · enumerated 2019 · authorized official Carla Bulla, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1790332351

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Registry record

Entity type Organization (Type 2)
Legal business name Pro Vita Physical Therapy LLC
Practice address 638 N Ferdon Blvd Ste 1, Crestview, FL, 32536
Phone (850) 331-3017
Fax (855) 975-2575
Enumeration date Aug 19, 2019
Last updated in NPPES Aug 29, 2022

Taxonomy & classification

225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225X00000X Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
261QP2000X Physical Therapy Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Carla Bulla
Title Owner
Phone (850) 902-7315

Other identifiers

Identifier Type State Issuer
8JY2N Other FL FLORIDA BLUE
103517900 Medicaid FL -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Pro Vita Physical Therapy LLC?
NPPES lists Carla Bulla (Owner) as the authorized official for this organization.
What is the NPI number for Pro Vita Physical Therapy LLC?
The NPI for Pro Vita Physical Therapy LLC is 1790332351, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-08-29.