Healthcare Provider Details
I. General information
NPI: 1366762890
Provider Name (Legal Business Name): THE WESTON GROUP OF FLORIDA I INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/07/2010
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2403 W HILLSBORO BLVD
DEERFIELD BEACH FL
33442-8507
US
IV. Provider business mailing address
2222 SULLIVAN TRL
EASTON PA
18040-7958
US
V. Phone/Fax
- Phone: 954-725-7676
- Fax: 954-725-7676
- Phone: 800-944-9782
- Fax: 610-438-2024
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RANDALL
A
WESTON
Title or Position: PRESIDENT/ OWNER
Credential: OTR/L
Phone: 800-944-9782