Provider Demographics
NPI:1619569803
Name:LEVEL UP THERAPY LLC
Entity Type:Organization
Organization Name:LEVEL UP THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-537-6877
Mailing Address - Street 1:393 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-3309
Mailing Address - Country:US
Mailing Address - Phone:786-537-6877
Mailing Address - Fax:
Practice Address - Street 1:393 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-3309
Practice Address - Country:US
Practice Address - Phone:786-451-4233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty