Organization
FUNCTIONALITY FOR LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER TREVINO OTR/L (OWNER)
(813) 442-1204
Entity
Organization
Contact information
Practice address
1234 KATAHDIN CT, WESLEY CHAPEL, FL 33543-6860
(813) 442-1204
Mailing address
1234 KATAHDIN CT, WESLEY CHAPEL, FL 33543-6860
(813) 442-1204
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XE0001X
Environmental Modification Occupational Therapist
—
—
225XG0600X
Gerontology Occupational Therapist
—
—
225XH1300X
Human Factors Occupational Therapist
—
—
225XL0004X
Low Vision Occupational Therapist
—
—
225XM0800X
Mental Health Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
10/14/2019
Last updated
10/07/2021
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