MEDICARE: PARADISE INMOTION 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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1962198390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARADISE INMOTION THERAPY

Provider Business Mailing Address
First Line	:	4837 SILVER TOPAZ ST
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34233-2435
Country	:	US
Telephone Number	:	941-726-4220
Fax Number	:

Provider Business Practice Location Address
First Line	:	4837 SILVER TOPAZ ST
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34233-2435
Country	:	US
Telephone Number	:	941-726-4220
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER/FOUNDER
Name	:	DR. AMANDA LAUGOIS MODERY
Credential	:	PT, DPT
Telephone Number	:	941-726-4220

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

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Directions to “PARADISE INMOTION THERAPY ” Practice Location

Language	Start Address	Practice Location

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