Organization
DYNAMIC PEDIATRIC THERAPY, INC.
Active
Other names
Dynamic Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ILEANA MARTINEZ (PRESIDENT)
(305) 242-9424
Entity
Organization
Contact information
Practice address
15600 SW 288TH ST STE 202, HOMESTEAD, FL 33033-1200
(305) 242-9424
Mailing address
3581 NE 11 DR, NONE, HOMESTEAD, FL 33033
(954) 682-7633
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OTA11461
FL
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001392900
—
FL
Enumeration date
12/01/2010
Last updated
11/06/2025
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