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General NPI Number Information
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NPI Number | 1134394257
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Entity Type | Organization
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Legal Business Name | RL THERAPY GROUP LLC
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 16322 OFFENHAUR RD
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City | ODESSA
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State | FL
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Zip | 33556-2328
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Country | US
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Telephone | 727-458-3667
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Fax | 813-920-8596
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Provider Business Mailing Address
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Address Line | 16322 OFFENHAUR ROAD
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City | ODESSA
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State | FL
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Zip | 33556
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Country | US
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Telephone | 727-458-3667
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Fax | 813-920-8596
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Authorized Official
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Title or Position | PRES
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Name | RANDALL CHARLES DEAN
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Credential |
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Telephone | 727-458-3667
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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 | OT 6632
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 7375
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License Number State | FL
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