Provider Demographics
NPI:1083904460
Name:PEDIATRIC THERAPY SOLUTIONS, INC.
Entity Type:Organization
Organization Name:PEDIATRIC THERAPY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MATTEOLI
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-266-7326
Mailing Address - Street 1:5899 WHITFIELD AVE
Mailing Address - Street 2:SUITE # 203
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-6152
Mailing Address - Country:US
Mailing Address - Phone:941-360-0200
Mailing Address - Fax:941-360-0200
Practice Address - Street 1:5899 WHITFIELD AVE
Practice Address - Street 2:SUITE # 203
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-6152
Practice Address - Country:US
Practice Address - Phone:941-360-0200
Practice Address - Fax:941-360-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA9969224Z00000X
FLOT10399225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL887541300Medicaid