=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497116024
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAREPLUS THERAPY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/09/2016
-----------------------------------------------------
Last Update Date | 03/13/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 796 BELLE GROVE LN
-----------------------------------------------------
City | ROYAL PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33411-4547
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-563-9343
-----------------------------------------------------
Fax | 561-342-4849
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10890 HANDEL PL
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33498-6762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-563-9343
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MGRM
-----------------------------------------------------
Name | MR. WILLIAM THOMAS DAMELIO
-----------------------------------------------------
Credential | M.S., CCC-SLP
-----------------------------------------------------
Telephone | 914-563-9343
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SZ7466
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------