Healthcare Provider Details

I. General information

NPI: 1487582821
Provider Name (Legal Business Name): INTERACTIVE THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 NW 10TH PL
CAPE CORAL FL
33993-5312
US

IV. Provider business mailing address

12220 SW 188TH TER
MIAMI FL
33177-3120
US

V. Phone/Fax

Practice location:
  • Phone: 786-258-5939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROLANDO LOPEZ
Title or Position: OWNER
Credential:
Phone: 786-258-5939