Healthcare Provider Details

I. General information

NPI: 1134918477
Provider Name (Legal Business Name): RESTO ENTERPRISE LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13922 58TH ST N STE 900
CLEARWATER FL
33760-3771
US

IV. Provider business mailing address

9007 W HAMILTON AVE
TAMPA FL
33615-2700
US

V. Phone/Fax

Practice location:
  • Phone: 724-999-3189
  • Fax: 727-222-1731
Mailing address:
  • Phone: 813-453-6891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PATRICE RESTO
Title or Position: CO-OWNER
Credential:
Phone: 813-407-8435