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NPI Code Detail

MEDICARE: SUNCOAST THERAPY, LLC

MEDICARE: SUNCOAST THERAPY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist
2225100000XPhysical Therapist
3225X00000XOccupational Therapist
4235Z00000XSpeech-Language Pathologist
5261QH0100XHealth Service Clinic/Center
6261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
7101YM0800XMental Health Counselor
81041C0700XClinical Social Worker
9261Q00000XClinic/Center

General Provider Information

NPI Number : 1013234608
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNCOAST THERAPY, LLC
Provider Business Mailing Address
First Line : PO BOX 631278
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-1278
Country : US
Telephone Number : 941-485-0121
Fax Number : 847-584-2604
Provider Business Practice Location Address
First Line : 2574 COMMERCE PKWY
Second Line :
City : NORTH PORT
State : FL
Zip : 34289-9334
Country : US
Telephone Number : 941-485-0121
Fax Number : 847-584-2604
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : JULIE BUSH
Credential :
Telephone Number : 847-584-2604
Provider Enumeration Date : 04/23/2010
Last Update Date : 09/14/2022

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Directions to “SUNCOAST THERAPY, LLC ” Practice Location

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