MEDICARE: JOYFUL MUSIC 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
1	174400000X	Specialist	08509	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1225224751	OTHER		NPI

General Provider Information

NPI Number	:	1437578390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOYFUL MUSIC THERAPY LLC

Provider Business Mailing Address
First Line	:	719 LEE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-5621
Country	:	US
Telephone Number	:	407-489-1783
Fax Number	:

Provider Business Practice Location Address
First Line	:	2435 LEE RD
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-1755
Country	:	US
Telephone Number	:	407-489-1783
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MISS TAMELA PONDER
Credential	:	MT-BC
Telephone Number	:	407-489-1783

Provider Enumeration Date	:	04/08/2014
Last Update Date	:	07/13/2016

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