Healthcare Provider Details

I. General information

NPI: 1194612028
Provider Name (Legal Business Name): U THRIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3777 VILLAMORE LN APT ODESSA
ODESSA FL
33556-4196
US

IV. Provider business mailing address

3777 VILLAMORE LN APT ODESSA
ODESSA FL
33556-4196
US

V. Phone/Fax

Practice location:
  • Phone: 919-943-7508
  • Fax:
Mailing address:
  • Phone: 919-943-7508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER R PIETRZYKOWSKI
Title or Position: OWNER
Credential: COTA/L
Phone: 919-943-7508