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Organization

BAYSIDE THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRYSTAL YOUNG COTA/L (CEO)
(321) 806-9395
Entity
Organization

Contact information

Practice address
2075 MEADOWLANE AVE, MELBOURNE, FL 32904-4951
(321) 806-9395
Mailing address
674 OLD COUNTRY RD SE, PALM BAY, FL 32909-6903
(321) 806-9395

Taxonomy

Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
225100000X
Physical Therapist
2251C2600X
Cardiopulmonary Physical Therapist
2251E1200X
Ergonomics Physical Therapist
2251N0400X
Neurology Physical Therapist
2251P0200X
Pediatric Physical Therapist
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
225XL0004X
Low Vision Occupational Therapist
225XM0800X
Mental Health Occupational Therapist
225XN1300X
Neurorehabilitation Occupational Therapist
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
227800000X
Certified Respiratory Therapist
2278P3900X
Neonatal/Pediatric Certified Respiratory Therapist
2355S0801X
Speech-Language Assistant
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
05/01/2025
Last updated
05/05/2025
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