MEDICARE: HEART 4 KIDS THERAPY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1962154948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART 4 KIDS THERAPY LLC

Provider Business Mailing Address
First Line	:	31840 US HIGHWAY 19 N
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3713
Country	:	US
Telephone Number	:	727-202-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	8817 MITCHELL BLVD
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-4407
Country	:	US
Telephone Number	:	727-202-1477
Fax Number	:	727-350-9665

Authorized Official
Title or Position	:	OWNER
Name	:	LACI COLEMAN
Credential	:
Telephone Number	:	727-202-9200

Provider Enumeration Date	:	01/21/2022
Last Update Date	:	01/21/2022

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Directions to “HEART 4 KIDS THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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