Healthcare Provider Details

I. General information

NPI: 1114594470
Provider Name (Legal Business Name): SPOTHERAPIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 RIEGLER RD
LAND O LAKES FL
34639-5328
US

IV. Provider business mailing address

6348 DISCOVERY LN
LAND O LAKES FL
34638-3132
US

V. Phone/Fax

Practice location:
  • Phone: 813-230-1337
  • Fax:
Mailing address:
  • Phone: 813-230-1337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: KELLY DOWNING
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 813-230-1337