Healthcare Provider Details

I. General information

NPI: 1013633031
Provider Name (Legal Business Name): FUNCTIONAL TRANSFORMATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5957 CATTLEMEN LN
SARASOTA FL
34232-6200
US

IV. Provider business mailing address

5957 CATTLEMEN LN
SARASOTA FL
34232-6200
US

V. Phone/Fax

Practice location:
  • Phone: 941-830-3749
  • Fax: 941-460-4494
Mailing address:
  • Phone: 941-371-1185
  • Fax: 941-460-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JAMES FERRARA
Title or Position: OWNER PROVIDER
Credential: OTR/L
Phone: 941-830-3749