MEDICARE: ADVANCED PEDIATRIC THERAPIES, 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	235Z00000X	Speech-Language Pathologist	SP 672	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	668131	OTHER	NV	BCBS

General Provider Information

NPI Number	:	1629148200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PEDIATRIC THERAPIES, LLC

Provider Business Mailing Address
First Line	:	1025 ROBERTA LN
Second Line	:
City	:	SPARKS
State	:	NV
Zip	:	89431-1893
Country	:	US
Telephone Number	:	775-825-4744
Fax Number	:	775-351-1644

Provider Business Practice Location Address
First Line	:	1625 E PRATER WAY STE 107
Second Line	:
City	:	SPARKS
State	:	NV
Zip	:	89434-8963
Country	:	US
Telephone Number	:	775-825-4744
Fax Number	:	775-351-1644

Authorized Official
Title or Position	:	OWNER DIRECTOR
Name	:	JULIE BEMUS ORTIZ
Credential	:	M.S. CCC SLP
Telephone Number	:	775-825-4744

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	06/06/2024

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Directions to “ADVANCED PEDIATRIC THERAPIES, LLC ” Practice Location

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