=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972397057
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAHEALTH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/05/2025
-----------------------------------------------------
Last Update Date | 04/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6021 DUVAL ST
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33024-7961
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-613-1163
-----------------------------------------------------
Fax | 954-613-1243
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6920 SW 56TH CT
-----------------------------------------------------
City | DAVIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33314-7004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-646-1212
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MICHAEL ROZENBERG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-646-1212
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------