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General NPI Number Information
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NPI Number | 1376682252
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Entity Type | Organization
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Legal Business Name | THERA-PEDS, INC.
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 11651 NW 32ND MNR
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City | SUNRISE
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State | FL
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Zip | 33323-1313
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Country | US
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Telephone | 954-572-5851
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Fax | 954-572-4301
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Provider Business Mailing Address
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Address Line | 11651 NW 32ND MNR
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City | SUNRISE
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State | FL
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Zip | 33323-1313
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Country | US
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Telephone | 954-572-5851
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Fax | 954-572-4301
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LISA CARLYLE
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Credential | OTR
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Telephone | 954-572-5851
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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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