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General NPI Number Information
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NPI Number | 1013448422
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Entity Type | Organization
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Legal Business Name | LOW VISION THERAPY OF SOUTHWEST FLORIDA LLC
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 8303 ESTERO BLVD
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City | FORT MYERS BEACH
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State | FL
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Zip | 33931-5104
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Country | US
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Telephone | 239-877-3932
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Fax |
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Provider Business Mailing Address
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Address Line | 8303 ESTERO BLVD
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City | FORT MYERS BEACH
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State | FL
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Zip | 33931-5104
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Country | US
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Telephone | 239-877-3932
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CINDY SUE BELLO
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Credential | OTR
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Telephone | 239-877-3932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3222
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225XL0004X
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Taxonomy Name | Low Vision Occupational Therapist
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License Number | 3222
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License Number State | FL
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