Healthcare Provider Details

I. General information

NPI: 1497199657
Provider Name (Legal Business Name): GAIT MECHANICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5145 WOODSTONE CIR E
LAKE WORTH FL
33463-5819
US

IV. Provider business mailing address

645 DANAS RIDGE DR
ROSWELL GA
30075-6352
US

V. Phone/Fax

Practice location:
  • Phone: 561-350-5855
  • Fax:
Mailing address:
  • Phone: 561-350-5855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT 19233
License Number StateFL

VIII. Authorized Official

Name: MRS. DANA SERRANO
Title or Position: PRESIDENT
Credential: MPT
Phone: 561-350-5855