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General NPI Number Information
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NPI Number | 1487091252
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Entity Type | Organization
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Legal Business Name | THERAFLEX LLC
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Dates
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Enumeration Date | 06/03/2013
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 600 N HIGHWAY 27 SUITE 5
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City | MINNEOLA
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State | FL
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Zip | 34715-6265
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Country | US
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Telephone | 352-874-6562
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Fax | 352-678-3419
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Provider Business Mailing Address
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Address Line | 600 N HIGHWAY 27 SUITE 5
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City | MINNEOLA
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State | FL
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Zip | 34715-6265
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Country | US
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Telephone | 352-874-6562
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Fax | 352-678-3419
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Authorized Official
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Title or Position | MANAGER
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Name | HEATHER M VAZ-ANTROBUS
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Credential | MPT
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Telephone | 352-874-6562
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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 | PT 22653
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License Number State | FL
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