MEDICARE: PROSPER THERAPY

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1679374144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROSPER THERAPY

Provider Business Mailing Address
First Line	:	35 SE 1ST AVE STE 200
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-2177
Country	:	US
Telephone Number	:	352-239-1550
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 SE 1ST AVE STE 200
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-2177
Country	:	US
Telephone Number	:	352-239-1550
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. LISA CANTRELL
Credential	:
Telephone Number	:	352-239-1550

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	04/24/2025

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Directions to “PROSPER THERAPY ” Practice Location

Language	Start Address	Practice Location

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