Healthcare Provider Details

I. General information

NPI: 1710505888
Provider Name (Legal Business Name): DEVELOPING MINDS HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2595 TAMPA RD STE A
PALM HARBOR FL
34684-3130
US

IV. Provider business mailing address

2595 TAMPA RD STE A
PALM HARBOR FL
34684-3130
US

V. Phone/Fax

Practice location:
  • Phone: 727-953-3228
  • Fax:
Mailing address:
  • Phone: 727-953-3228
  • Fax: 727-953-3486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DEANNA LYNN MARR
Title or Position: OWNER
Credential: OTR
Phone: 813-358-3274