Healthcare Provider Details

I. General information

NPI: 1942541420
Provider Name (Legal Business Name): THERAPEUTICFX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2013
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 E OAK ST
ARCADIA FL
34266-8902
US

IV. Provider business mailing address

1311 E OAK ST
ARCADIA FL
34266-8902
US

V. Phone/Fax

Practice location:
  • Phone: 863-491-7055
  • Fax: 863-491-7056
Mailing address:
  • Phone: 941-204-0745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 10572
License Number StateFL

VIII. Authorized Official

Name: KHALED TEMRAZ
Title or Position: OWNER
Credential: DPT
Phone: 863-491-7055