=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841769296
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPY NETWORK SOLUTIONS LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2018
-----------------------------------------------------
Last Update Date | 11/15/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9299 SW 152ND ST STE 200
-----------------------------------------------------
City | PALMETTO BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-1776
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-244-5883
-----------------------------------------------------
Fax | 305-407-1782
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9299 SW 152ND ST STE 200
-----------------------------------------------------
City | PALMETTO BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-1776
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-244-5883
-----------------------------------------------------
Fax | 305-407-1782
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. ANDY ZAPATA
-----------------------------------------------------
Credential | OT
-----------------------------------------------------
Telephone | 305-244-5883
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------