Healthcare Provider Details
I. General information
NPI: 1679929632
Provider Name (Legal Business Name): SOMI THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2016
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6601 SW 80TH ST SUITE 107
SOUTH MIAMI FL
33143-4661
US
IV. Provider business mailing address
6601 SW 80TH ST SUITE 107
SOUTH MIAMI FL
33143-4661
US
V. Phone/Fax
- Phone: 305-680-9707
- Fax: 888-680-9708
- Phone: 305-680-9707
- Fax: 888-680-9708
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0019X |
| Taxonomy | Physical Rehabilitation Occupational Therapist |
| License Number | OT13177 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | OT11756 |
| License Number State | FL |
VIII. Authorized Official
Name:
CHRISTINE
BETANCOURT
Title or Position: OWNER / OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 305-680-9707