Organization
ACTIVE HEALTH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIA M. RUPE MS OTR/L MLD-CLT (MGRM/DIRECTOR)
(772) 539-0393
Entity
Organization
Contact information
Practice address
916 TIDES RD, VERO BEACH, FL 32963-1261
(772) 539-0393
Mailing address
916 TIDES RD STE E-100, VERO BEACH, FL 32963-1261
(772) 539-0393
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
OT9610
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892281100
—
FL
Enumeration date
05/29/2008
Last updated
07/30/2020
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