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General NPI Number Information
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NPI Number | 1740079524
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Entity Type | Organization
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Legal Business Name | SOS OF GULF BREEZE INC.
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 2990 GULF BREEZE PKWY
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City | GULF BREEZE
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State | FL
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Zip | 32563-3100
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Country | US
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Telephone | 850-324-7702
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CHANTECLAIRE CIR
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City | GULF BREEZE
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State | FL
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Zip | 32561-4061
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Country | US
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Telephone | 850-324-7702
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Fax | 850-324-7702
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Authorized Official
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Title or Position | OWNER
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Name | RYAN PEAT
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Credential |
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Telephone | 850-324-7702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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