Organization
IMMERSED PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJA PERRY MS, ORT/L (OCCUPATIONAL THERAPIST)
(904) 304-0434
Entity
Organization
Contact information
Practice address
6915 SURREY OAK DR, APOLLO BEACH, FL 33572-1531
(813) 400-3265
Mailing address
2424 W BRANDON BLVD # 1023, BRANDON, FL 33511-4717
(813) 400-3265
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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