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General NPI Number Information
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NPI Number | 1053940114
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Entity Type | Organization
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Legal Business Name | REALTIME THERAPY, PLLC
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 815 NW 79TH TER
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City | PLANTATION
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State | FL
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Zip | 33324-1453
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Country | US
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Telephone | 917-676-5493
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 NW 79TH AVE STE 245 #1029
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City | DORAL
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State | FL
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Zip | 33166-6506
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Country | US
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Telephone | 917-676-5493
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Fax |
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Authorized Official
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Title or Position | FOUNDER & CEO
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Name | ASHER OLLIVIERRE
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Credential | OTD, OTR/L
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Telephone | 917-676-5493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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