Healthcare Provider Details

I. General information

NPI: 1457238826
Provider Name (Legal Business Name): FLORIDA THERAPY & EVALUATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9541 103RD ST APT 1221
JACKSONVILLE FL
32210-0338
US

IV. Provider business mailing address

9541 103RD ST APT 1221
JACKSONVILLE FL
32210-0338
US

V. Phone/Fax

Practice location:
  • Phone: 850-264-3053
  • Fax:
Mailing address:
  • Phone: 850-264-3053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name: TESHAUNDRIA WESTON
Title or Position: OWNER
Credential:
Phone: 850-264-3053