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Organization
EASTER SEALS SOUTHWEST FLORIDA, NOKOMIS
Active
Organization
EASTER SEALS SOUTHWEST FLORIDA, NOKOMIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM WATERS (CEO)
(941) 355-7637
Entity
Organization
Contact information
Practice address
1629 RANCH RD, NOKOMIS, FL 34275-1708
(941) 355-7637
Mailing address
350 BRADEN AVE, SARASOTA, FL 34243-2001
(941) 355-7637
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
12/04/2020
Last updated
12/07/2020
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