Provider Demographics
NPI:1578272902
Name:OT FOR LIFE THERAPY SERVICES INC
Entity Type:Organization
Organization Name:OT FOR LIFE THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:EYNAUDI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:954-557-8190
Mailing Address - Street 1:14060 SW 37TH CT
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1517
Mailing Address - Country:US
Mailing Address - Phone:954-557-8190
Mailing Address - Fax:
Practice Address - Street 1:14060 SW 37TH CT
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-1517
Practice Address - Country:US
Practice Address - Phone:954-557-8190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1447851142Medicaid