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Organization
THERA-PEDS, II LLC
Active
Organization
THERA-PEDS, II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA CARLYLE (PARTNER)
(561) 748-6300
Entity
Organization
Contact information
Practice address
10152 W INDIANTOWN RD STE 222, JUPITER, FL 33478-4707
(561) 748-6300
Mailing address
10152 W INDIANTOWN RD STE 222, JUPITER, FL 33478-4707
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 9427
FL
225X00000X
Occupational Therapist
Primary
OT 3489
FL
235Z00000X
Speech-Language Pathologist
SA 5594
FL
Other
Enumeration date
07/27/2007
Last updated
07/27/2007
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