Healthcare Provider Details

I. General information

NPI: 1902126436
Provider Name (Legal Business Name): THE WESTON GROUP OF FLORIDA I INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8951 BONITA BEACH RD SE SUITE 297
BONITA SPRINGS FL
34135-4201
US

IV. Provider business mailing address

2222 SULLIVAN TRL
EASTON PA
18040-7958
US

V. Phone/Fax

Practice location:
  • Phone: 239-992-5513
  • Fax:
Mailing address:
  • Phone: 800-944-9782
  • Fax: 610-438-2046

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 Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: RANDALL A WESTON
Title or Position: PRESIDENT/OWNER
Credential: OTR/L
Phone: 800-944-9782