Provider Demographics
NPI:1235399197
Name:CENTRAL FLORIDA THERAPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CENTRAL FLORIDA THERAPY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGNUSON
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:352-454-3437
Mailing Address - Street 1:8686A E COUNTY ROAD 466
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-3670
Mailing Address - Country:US
Mailing Address - Phone:352-454-3437
Mailing Address - Fax:352-245-4342
Practice Address - Street 1:8686A E COUNTY ROAD 466
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-3670
Practice Address - Country:US
Practice Address - Phone:352-454-3437
Practice Address - Fax:352-245-4342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA-8858224Z00000X
FLOT-8946225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty