Healthcare Provider Details

I. General information

NPI: 1780902726
Provider Name (Legal Business Name): LEVERAGE HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2010
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 E OAKLAND PARK BLVD SUITE 5
FORT LAUDERDALE FL
33306-1662
US

IV. Provider business mailing address

2655 E OAKLAND PARK BLVD SUITE 5
FORT LAUDERDALE FL
33306-1662
US

V. Phone/Fax

Practice location:
  • Phone: 954-630-3131
  • Fax: 954-630-3132
Mailing address:
  • Phone: 954-630-3131
  • Fax: 954-630-3132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number22123
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MATEO JAMES MARTINEZ
Title or Position: PRESIDENT/PHYSICAL THERAPIST
Credential: PT
Phone: 954-993-6299