Provider Demographics
NPI:1235320813
Name:MYTHERAPY, INC.
Entity Type:Organization
Organization Name:MYTHERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GEORGIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LAS POZAS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:305-798-3498
Mailing Address - Street 1:13441 SW 62ND ST
Mailing Address - Street 2:4
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5134
Mailing Address - Country:US
Mailing Address - Phone:305-798-3498
Mailing Address - Fax:305-408-0553
Practice Address - Street 1:13441 SW 62ND ST
Practice Address - Street 2:4
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-5134
Practice Address - Country:US
Practice Address - Phone:305-798-3498
Practice Address - Fax:305-408-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT187012251P0200X
FLOT8736225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty