Healthcare Provider Details

I. General information

NPI: 1285538843
Provider Name (Legal Business Name): ST MICHAEL THERAPY STAFFING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1054 BRYCE LN
WEST MELBOURNE FL
32904-8718
US

IV. Provider business mailing address

1054 BRYCE LN
WEST MELBOURNE FL
32904-8718
US

V. Phone/Fax

Practice location:
  • Phone: 321-405-9043
  • Fax:
Mailing address:
  • Phone: 321-405-9043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. RITCHIE CHENFOO
Title or Position: OWNER
Credential: PT
Phone: 321-405-9043