Healthcare Provider Details

I. General information

NPI: 1225673049
Provider Name (Legal Business Name): AURA'S THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2019
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3115 CITRUS TOWER BLVD STE D
CLERMONT FL
34711-6880
US

IV. Provider business mailing address

278 SPARROW HAWK DR
GROVELAND FL
34736-8058
US

V. Phone/Fax

Practice location:
  • Phone: 407-374-8010
  • Fax: 407-536-5801
Mailing address:
  • Phone: 407-340-5047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
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: MR. RAUL BRAVO
Title or Position: OWNER
Credential:
Phone: 407-340-6891