Healthcare Provider Details

I. General information

NPI: 1760581789
Provider Name (Legal Business Name): SOUTH FLORIDA HAND THERAPY ASSOC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10189 SUNRISE BLVD
PLANTATION FL
33322
US

IV. Provider business mailing address

10189 SUNRISE BLVD
PLANTATION FL
33322
US

V. Phone/Fax

Practice location:
  • Phone: 954-236-6770
  • Fax: 954-236-6771
Mailing address:
  • Phone: 954-236-6770
  • Fax: 954-236-6771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberOT0000761
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberOT0000761
License Number StateFL

VIII. Authorized Official

Name: SUSAN BURNS
Title or Position: OWNER
Credential: OTR/L, CHT
Phone: 954-236-6770