Healthcare Provider Details

I. General information

NPI: 1386701332
Provider Name (Legal Business Name): INFANT AND PEDIATRIC HOME THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 SE 4TH CT
DANIA BEACH FL
33004-4738
US

IV. Provider business mailing address

550 SE 4TH CT
DANIA BEACH FL
33004-4738
US

V. Phone/Fax

Practice location:
  • Phone: 954-925-7034
  • Fax: 954-925-7034
Mailing address:
  • Phone: 954-925-7034
  • Fax: 954-925-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
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: MRS. MICHELLE JOANNE PARENTE
Title or Position: OWNER, PEDIATRIC P.T.
Credential: P.T.
Phone: 954-925-7034