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General NPI Number Information
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NPI Number | 1265369193
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Entity Type | Organization
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Legal Business Name | PLAY PATCH THERAPY
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 5234 SW 159TH AVE
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City | MIRAMAR
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State | FL
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Zip | 33027-4993
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Country | US
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Telephone | 954-701-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 5234 SW 159TH AVE
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City | MIRAMAR
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State | FL
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Zip | 33027-4993
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Country | US
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Telephone | 954-701-7500
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | TIFFANY ALEXANDRA GONZALEZ
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Credential | OTR/L
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Telephone | 954-701-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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