Provider Demographics
NPI:1639586415
Name:VIVA PEDIATRIC THERAPY INC
Entity Type:Organization
Organization Name:VIVA PEDIATRIC THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANASTASIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOIKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-440-8066
Mailing Address - Street 1:1598 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-6531
Mailing Address - Country:US
Mailing Address - Phone:614-440-8066
Mailing Address - Fax:
Practice Address - Street 1:450 NW 14TH AVE
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-3230
Practice Address - Country:US
Practice Address - Phone:614-440-8066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty