Healthcare Provider Details

I. General information

NPI: 1073138012
Provider Name (Legal Business Name): LIMITLESS THERAPY, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13604 PALMERA VISTA DR
RIVERVIEW FL
33579-3529
US

IV. Provider business mailing address

13604 PALMERA VISTA DR
RIVERVIEW FL
33579-3529
US

V. Phone/Fax

Practice location:
  • Phone: 954-895-6151
  • Fax:
Mailing address:
  • Phone: 954-895-6151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: REBECCA PETROVICH
Title or Position: OWNER
Credential: MOT, OTR/L
Phone: 954-895-6151