Basic Information
| Provider Information | |||||||||
| NPI: | 1316339641 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL FLORIDA THERAPY SOLUTIONS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 455 W WARREN AVE | ||||||||
| Address2: | 200 | ||||||||
| City: | LONGWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327504002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072600551 | ||||||||
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| Practice Location | |||||||||
| Address1: | 455 W WARREN AVE | ||||||||
| Address2: | 200 | ||||||||
| City: | LONGWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327504002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072600551 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2015 | ||||||||
| LastUpdateDate: | 02/24/2015 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSTON | ||||||||
| AuthorizedOfficialFirstName: | NANCY | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER, SLP | ||||||||
| AuthorizedOfficialTelephone: | 4072600551 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | M.S. CCC-SLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT22868 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.