MEDICARE: VIP 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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1720775018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIP THERAPY LLC

Provider Business Mailing Address
First Line	:	3454 TRINITY ST
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34291-6327
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3454 TRINITY ST
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34291-6327
Country	:	US
Telephone Number	:	570-677-2786
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	STEPHANIE SKURSKI
Credential	:	OTR/L
Telephone Number	:	570-677-2786

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	04/18/2023

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Directions to “VIP THERAPY LLC ” Practice Location

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