Healthcare Provider Details

I. General information

NPI: 1760794077
Provider Name (Legal Business Name): OCEAN THERAPY GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 06/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HYPOLUXO RD SUITE 104
LANTANA FL
33462-4271
US

IV. Provider business mailing address

1111 HYPOLUXO RD SUITE 107
LANTANA FL
33462-4271
US

V. Phone/Fax

Practice location:
  • Phone: 561-557-5702
  • Fax: 561-557-5662
Mailing address:
  • Phone: 561-586-3400
  • Fax: 561-585-0079

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: DR. STEPHEN LOUIS NEMEROFSKY
Title or Position: VICE PRESIDENT
Credential: M.D.
Phone: 561-586-3400