MEDICARE: CONSISTENT THERAPY, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW10002	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HN426A	OTHER	FL	MEDICARE

General Provider Information

NPI Number	:	1104270776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONSISTENT THERAPY, LLC.

Provider Business Mailing Address
First Line	:	17407 BRIDGE HILL CT
Second Line	:	SUITE I
City	:	TAMPA
State	:	FL
Zip	:	33647-3522
Country	:	US
Telephone Number	:	813-400-3368
Fax Number	:

Provider Business Practice Location Address
First Line	:	17407 BRIDGE HILL CT
Second Line	:	SUITE I
City	:	TAMPA
State	:	FL
Zip	:	33647-3522
Country	:	US
Telephone Number	:	813-400-3368
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	PROF. MADELINE CINTRON-HALL
Credential	:	LCSW
Telephone Number	:	813-400-3368

Provider Enumeration Date	:	04/19/2016
Last Update Date	:	07/18/2016

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