Provider Demographics
NPI:1578862801
Name:NASH THERAPY INC
Entity Type:Organization
Organization Name:NASH THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SLOVIK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, LMT
Authorized Official - Phone:321-432-9028
Mailing Address - Street 1:704 S PATRICK DR
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3804
Mailing Address - Country:US
Mailing Address - Phone:321-426-8756
Mailing Address - Fax:188-831-4135
Practice Address - Street 1:704 S PATRICK DR
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3804
Practice Address - Country:US
Practice Address - Phone:321-426-8756
Practice Address - Fax:188-831-4135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT13217225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty