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General NPI Number Information
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NPI Number | 1235320813
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Entity Type | Organization
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Legal Business Name | MYTHERAPY, INC.
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 13441 SW 62ND ST 4
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City | MIAMI
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State | FL
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Zip | 33183-5134
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Country | US
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Telephone | 305-798-3498
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Fax | 305-408-0553
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Provider Business Mailing Address
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Address Line | 13441 SW 62ND ST 4
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City | MIAMI
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State | FL
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Zip | 33183-5134
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Country | US
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Telephone | 305-798-3498
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Fax | 305-408-0553
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GEORGIA DE LAS POZAS
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Credential | OTR
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Telephone | 305-798-3498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT18701
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT8736
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License Number State | FL
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