Healthcare Provider Details

I. General information

NPI: 1275740995
Provider Name (Legal Business Name): LYMPHATX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 NW 13TH ST SUITE 102
BOCA RATON FL
33486-2269
US

IV. Provider business mailing address

1001 NW 13TH ST SUITE 102
BOCA RATON FL
33486-2269
US

V. Phone/Fax

Practice location:
  • Phone: 561-392-5131
  • Fax: 561-392-5161
Mailing address:
  • Phone: 561-392-5131
  • Fax: 561-392-5161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT13249
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. PAMELA FREEDMAN COHEN
Title or Position: OWNER-DIRECTOR
Credential: RPT-CLT
Phone: 561-392-5131