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General NPI Number Information
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NPI Number | 1366784688
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Entity Type | Organization
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Legal Business Name | LIBERTY OF WEST PALM BEACH
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Dates
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Enumeration Date | 03/25/2013
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 3000 CENTRAL GARDENS CIR
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-8700
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Country | US
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Telephone | 561-644-4186
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Fax | 561-536-5528
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Provider Business Mailing Address
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Address Line | 1601 BELVEDERE RD STE 407S
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-1518
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Country | US
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Telephone | 561-644-4186
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Fax | 616-607-5555
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Authorized Official
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Title or Position | REHAB DIRECTOR
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Name | MRS. MARIA FITOS
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Credential | PTA
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Telephone | 561-644-4186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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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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