Provider Demographics
NPI:1174639272
Name:DLJ THERAPY SERVICES INC
Entity Type:Organization
Organization Name:DLJ THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LINARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-484-6563
Mailing Address - Street 1:PO BOX 140132
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-0123
Mailing Address - Country:US
Mailing Address - Phone:407-484-6563
Mailing Address - Fax:
Practice Address - Street 1:8138 SUN VISTA WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-7538
Practice Address - Country:US
Practice Address - Phone:407-484-6563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11106225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty