MEDICARE: FOCUS SPOT LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	225100000X	Physical Therapist
3	235Z00000X	Speech-Language Pathologist
4	252Y00000X	Early Intervention Provider Agency
5	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1891481115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOCUS SPOT LLC

Provider Business Mailing Address
First Line	:	30 N GOULD ST STE N
Second Line	:
City	:	SHERIDAN
State	:	WY
Zip	:	82801-6317
Country	:	US
Telephone Number	:	718-690-0770
Fax Number	:

Provider Business Practice Location Address
First Line	:	4505 BEDFORD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2524
Country	:	US
Telephone Number	:	718-690-0770
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	VALENTINA RUVINOVA
Credential	:	OTR/L
Telephone Number	:	718-690-0770

Provider Enumeration Date	:	04/11/2023
Last Update Date	:	04/11/2023

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Directions to “FOCUS SPOT LLC ” Practice Location

Language	Start Address	Practice Location

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