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General NPI Number Information
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NPI Number | 1649661679
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Entity Type | Organization
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Legal Business Name | BREAKTHROUGH THERAPY, LLC
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 7232 SW 39TH TER
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City | MIAMI
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State | FL
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Zip | 33155-6624
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Country | US
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Telephone | 786-409-3254
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Fax | 786-452-7955
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Provider Business Mailing Address
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Address Line | 16514 SW 48TH TER
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City | MIAMI
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State | FL
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Zip | 33185-5141
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OCCUPATIONAL THERAPIST
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Name | MRS. VANESSA IGLESIAS-MACHADO
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Credential | M.S., OTR/L
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Telephone | 786-409-3254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric 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 | 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 #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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Taxonomy #4
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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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