Provider Demographics
NPI:1275740995
Name:LYMPHATX INC
Entity Type:Organization
Organization Name:LYMPHATX INC
Other - Org Name:LYMPHATICS PLUS OF BOCA RATON, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:FREEDMAN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT-CLT
Authorized Official - Phone:561-392-5131
Mailing Address - Street 1:1001 NW 13TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2269
Mailing Address - Country:US
Mailing Address - Phone:561-392-5131
Mailing Address - Fax:561-392-5161
Practice Address - Street 1:1001 NW 13TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2269
Practice Address - Country:US
Practice Address - Phone:561-392-5131
Practice Address - Fax:561-392-5161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT13249225100000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9173Medicare ID - Type Unspecified