Basic Information
| Provider Information | |||||||||
| NPI: | 1275120529 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SETH | ||||||||
| FirstName: | ARVIND | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 405 BREAKAWAY TRL | ||||||||
| Address2: | |||||||||
| City: | TITUSVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327807283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3217470069 | ||||||||
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| Practice Location | |||||||||
| Address1: | VERTIS THERAPY SEASIDE MANOR | ||||||||
| Address2: | 1050 OCEAN SHORE BLVD | ||||||||
| City: | ORMOND BEACH, | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321764126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172043736 | ||||||||
| FaxNumber: | 3177086496 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2020 | ||||||||
| LastUpdateDate: | 02/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 21330 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.