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General NPI Number Information
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NPI Number | 1164231718
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Entity Type | Organization
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Legal Business Name | HT 2.0 PEDIATRIC THERAPY PLLC
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 3270 SUNTREE BLVD STE 1117E
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City | MELBOURNE
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State | FL
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Zip | 32940-7556
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Country | US
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Telephone | 989-450-6441
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Fax |
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Provider Business Mailing Address
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Address Line | 1343 GLENEAGLES WAY
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2522
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Country | US
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Telephone | 989-450-6441
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NICKOLAS HETHERINGTON
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Credential | MOT, OTR/L
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Telephone | 989-450-6441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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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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Taxonomy #3
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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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