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General NPI Number Information
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NPI Number | 1619569803
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Entity Type | Organization
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Legal Business Name | LEVEL UP THERAPY LLC
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Dates
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Enumeration Date | 02/09/2021
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 393 NW 3RD ST
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City | FLORIDA CITY
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State | FL
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Zip | 33034-3309
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Country | US
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Telephone | 786-451-4233
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Fax |
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Provider Business Mailing Address
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Address Line | 393 NW 3RD ST
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City | FLORIDA CITY
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State | FL
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Zip | 33034-3309
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Country | US
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Telephone | 786-537-6877
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. DAVID DANA
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Credential |
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Telephone | 786-537-6877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational 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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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