Organization
THERA PEDS II LLC
Active
Organization
THERA PEDS II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA CARLYLE (PRESIDENT)
(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
(561) 748-6300
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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