Organization
ACTIVA, LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSCAR G. FERREIRA (ADMINISTRATIVE MANAGER)
(954) 374-0160
Entity
Organization
Contact information
Practice address
9720 STIRLING RD, SUITE 104, COOPER CITY, FL 33024-8014
(954) 374-0160
(954) 374-0163
Mailing address
9720 STIRLING RD, SUITE 104, COOPER CITY, FL 33024-8014
(954) 374-0160
(954) 374-0163
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251G0304X
Geriatric Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
225XG0600X
Gerontology Occupational Therapist
—
—
225XL0004X
Low Vision Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686623996
—
FL
05
—
889541400
—
FL
Enumeration date
06/10/2005
Last updated
04/02/2010
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