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General NPI Number Information
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NPI Number | 1114594470
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Entity Type | Organization
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Legal Business Name | SPOTHERAPIES LLC
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 2017 RIEGLER RD
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City | LAND O LAKES
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State | FL
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Zip | 34639-5328
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Country | US
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Telephone | 813-230-1337
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Fax |
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Provider Business Mailing Address
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Address Line | 6348 DISCOVERY LN
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City | LAND O LAKES
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State | FL
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Zip | 34638-3132
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Country | US
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Telephone | 813-230-1337
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | KELLY DOWNING
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Credential |
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Telephone | 813-230-1337
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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 |
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License Number State |
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Taxonomy #2
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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 #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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