Provider Demographics
NPI:1114403839
Name:THERAPY MASTERS OF FLORIDA, LLC
Entity Type:Organization
Organization Name:THERAPY MASTERS OF FLORIDA, LLC
Other - Org Name:THERAPY MASTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WETHERINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:813-763-5199
Mailing Address - Street 1:635 MIDFLORIDA DR STE 2
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-4923
Mailing Address - Country:US
Mailing Address - Phone:813-763-5199
Mailing Address - Fax:863-646-3299
Practice Address - Street 1:635 MIDFLORIDA DR STE 2
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-4923
Practice Address - Country:US
Practice Address - Phone:813-763-5199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA13788235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty