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Organization
SUPREME THERAPY, LLC
Active
Organization
SUPREME THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOANNES MARIA CLAESSENS P.T. (MANAGING MEMBER)
(407) 321-8833
Entity
Organization
Contact information
Practice address
770 KEENELAND PIKE, LAKE MARY, FL 32746-3951
(407) 321-8833
(407) 322-9966
Mailing address
770 KEENELAND PIKE, LAKE MARY, FL 32746-3951
(407) 321-8833
(407) 322-9966
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT16865
FL
225X00000X
Occupational Therapist
Primary
OT215
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y066A
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/19/2006
Last updated
09/11/2025
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