MEDICARE: FUNCTIONAL TRANSFORMATION 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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	225X00000X	Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013633031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUNCTIONAL TRANSFORMATION LLC

Provider Business Mailing Address
First Line	:	5957 CATTLEMEN LN
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-6200
Country	:	US
Telephone Number	:	941-371-1185
Fax Number	:	941-460-4494

Provider Business Practice Location Address
First Line	:	5957 CATTLEMEN LN
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-6200
Country	:	US
Telephone Number	:	941-830-3749
Fax Number	:	941-460-4494

Authorized Official
Title or Position	:	OWNER PROVIDER
Name	:	JAMES FERRARA
Credential	:	OTR/L
Telephone Number	:	941-830-3749

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	03/07/2025

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Directions to “FUNCTIONAL TRANSFORMATION LLC ” Practice Location

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