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General NPI Number Information
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NPI Number | 1356917165
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Entity Type | Organization
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Legal Business Name | R THERAPY LLC
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 9225 SW 158TH LN STE C
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1825
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Country | US
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Telephone | 786-395-4857
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Fax |
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Provider Business Mailing Address
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Address Line | 9225 SW 158TH LN STE C
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1825
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Country | US
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Telephone | 786-395-4857
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DIANA CARTAYA REYES
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Credential |
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Telephone | 786-395-4857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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