Healthcare Provider Details

I. General information

NPI: 1861816589
Provider Name (Legal Business Name): HOTEP HANDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2014
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 MIDYETTE RD APT 103
TALLAHASSEE FL
32301-6255
US

IV. Provider business mailing address

2014 MIDYETTE RD APT 103
TALLAHASSEE FL
32301-6255
US

V. Phone/Fax

Practice location:
  • Phone: 850-728-7947
  • Fax:
Mailing address:
  • Phone: 850-728-7947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberPT 23322
License Number StateFL

VIII. Authorized Official

Name: ADRIANNE BATE
Title or Position: PHYSICAL THERAPIST
Credential: PT, LMT
Phone: 850-728-7947