Organization
FLORIDA THERAPY PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA JEAN MATTHEWS (MANAGER)
(813) 240-2299
Entity
Organization
Contact information
Practice address
4011 W DE LEON ST, TAMPA, FL 33609-4416
(813) 240-2299
(813) 385-9034
Mailing address
4011 W DE LEON ST, TAMPA, FL 33609-4416
(813) 240-2299
(813) 385-9034
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
886771200
—
FL
Enumeration date
09/24/2018
Last updated
09/24/2018
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