Healthcare Provider Details
I. General information
NPI: 1902762529
Provider Name (Legal Business Name): LIMITLESS LEAPS PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6455 MALALUKA RD
NORTH PORT FL
34287-2150
US
IV. Provider business mailing address
7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US
V. Phone/Fax
- Phone: 630-640-6643
- Fax:
- Phone: 630-640-6643
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 222Q00000X |
| Taxonomy | Developmental Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAUREN
MCKEVITT
Title or Position: PROVIDER
Credential: DPT
Phone: 630-640-6643