Healthcare Provider Details

I. General information

NPI: 1265893408
Provider Name (Legal Business Name): INTEGRITY THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HUNT TRACE BLVD
CLERMONT FL
34711-5184
US

IV. Provider business mailing address

PO BOX 8939
LAKELAND FL
33806-8939
US

V. Phone/Fax

Practice location:
  • Phone: 863-617-9400
  • Fax: 863-688-9858
Mailing address:
  • Phone: 863-617-9400
  • Fax: 863-688-9858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH WHITEHURST
Title or Position: PRESIDENT
Credential: PT
Phone: 863-617-9400