MEDICARE: THERPY IQ 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	246Z00000X	Other Specialist/Technologist

General Provider Information

NPI Number	:	1639846587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERPY IQ LLC

Provider Business Mailing Address
First Line	:	11765 66TH AVE
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-6118
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 W CASS ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-1307
Country	:	US
Telephone Number	:	727-599-5762
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NATHAN MAINGI
Credential	:
Telephone Number	:	727-599-5762

Provider Enumeration Date	:	08/27/2021
Last Update Date	:	08/27/2021

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Directions to “THERPY IQ LLC ” Practice Location

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