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NPI Code Detail

MEDICARE: COCOA RIVER THERAPY, LLC

MEDICARE: COCOA RIVER 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
1261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1952835712
Entity Type Code : Organization
Provider Name (Legal Business Name) : COCOA RIVER THERAPY, LLC
Provider Business Mailing Address
First Line : 1835 NE MIAMI GARDENS DR STE 157
Second Line :
City : NORTH MIAMI BEACH
State : FL
Zip : 33179-5035
Country : US
Telephone Number : 786-279-1134
Fax Number : 786-513-2499
Provider Business Practice Location Address
First Line : 700 S 29TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-3626
Country : US
Telephone Number : 786-279-1134
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF FINANCE
Name : FANNY ALFONSO
Credential :
Telephone Number : 786-279-1134
Provider Enumeration Date : 04/18/2017
Last Update Date : 04/18/2017

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Directions to “COCOA RIVER THERAPY, LLC ” Practice Location

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