Provider Demographics
NPI:1285830240
Name:THERAPY CENTER OF OKEECHOBEE, INC.
Entity Type:Organization
Organization Name:THERAPY CENTER OF OKEECHOBEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DURAND
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:863-357-4994
Mailing Address - Street 1:306 NE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-2949
Mailing Address - Country:US
Mailing Address - Phone:863-357-4994
Mailing Address - Fax:863-357-4912
Practice Address - Street 1:306 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-2949
Practice Address - Country:US
Practice Address - Phone:863-357-4994
Practice Address - Fax:863-357-4912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLZ0249Z225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1194450001OtherPTRAN
FL1194450001OtherPTRAN