Healthcare Provider Details

I. General information

NPI: 1609694512
Provider Name (Legal Business Name): LYMPHATX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10075 S JOG RD STE 201
BOYNTON BEACH FL
33437-3536
US

IV. Provider business mailing address

7301 W PALMETTO PARK RD STE 101C
BOCA RATON FL
33433-3455
US

V. Phone/Fax

Practice location:
  • Phone: 561-733-1012
  • Fax: 561-733-1042
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 Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PAMELA FREEDMAN COHEN
Title or Position: OWNER, DIRECTOR
Credential: RPT-CLT/LANA
Phone: 561-392-5131