Healthcare Provider Details

I. General information

NPI: 1275346496
Provider Name (Legal Business Name): EFOT CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11066 SW 247TH TER
HOMESTEAD FL
33032-4693
US

IV. Provider business mailing address

11066 SW 247TH TER
HOMESTEAD FL
33032-4693
US

V. Phone/Fax

Practice location:
  • Phone: 305-321-8650
  • Fax:
Mailing address:
  • Phone: 305-321-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: EDUARDO FERNANDEZ
Title or Position: CEO
Credential:
Phone: 305-321-8650