Healthcare Provider Details
I. General information
NPI: 1740690460
Provider Name (Legal Business Name): THERAPY SPECIALIST SERVICES 1 INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2014
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18951 SW 106TH AVE STE 105-106
CUTLER BAY FL
33157-7668
US
IV. Provider business mailing address
18951 SW 106TH AVE STE 105-106
CUTLER BAY FL
33157-7668
US
V. Phone/Fax
- Phone: 305-233-4448
- Fax: 305-760-4704
- Phone: 305-233-4448
- Fax: 305-760-4704
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT24738 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | OTR14201 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SA11940 |
| License Number State | FL |
VIII. Authorized Official
Name:
MARIA
MESA
Title or Position: CEO
Credential:
Phone: 305-233-4448