MEDICARE: PUZZLY MINDS 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	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1437947132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUZZLY MINDS THERAPY, LLC

Provider Business Mailing Address
First Line	:	4050 DINNER LAKE WAY
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33859-2105
Country	:	US
Telephone Number	:	863-837-0895
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 21ST ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-3461
Country	:	US
Telephone Number	:	863-837-0895
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ALICE RYMER
Credential	:
Telephone Number	:	863-837-0895

Provider Enumeration Date	:	04/30/2025
Last Update Date	:	04/30/2025

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