Healthcare Provider Details

I. General information

NPI: 1508482068
Provider Name (Legal Business Name): SPECIALIZED THERAPY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2020
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6174 CLARK CENTER AVENUE
SARASOTA FL
34238
US

IV. Provider business mailing address

6174 CLARK CENTER AVENUE
SARASOTA FL
34238
US

V. Phone/Fax

Practice location:
  • Phone: 941-752-6566
  • Fax:
Mailing address:
  • Phone: 941-752-6566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LISA KAREN RATCLIFFE
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: PT
Phone: 941-752-6566