Provider Demographics
NPI:1639613615
Name:RECREATION AND LEISURE PLUS INC
Entity Type:Organization
Organization Name:RECREATION AND LEISURE PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIL
Authorized Official - Suffix:
Authorized Official - Credentials:CTRS
Authorized Official - Phone:954-599-4620
Mailing Address - Street 1:6320 MIRAMAR PKWY
Mailing Address - Street 2:STE F
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3999
Mailing Address - Country:US
Mailing Address - Phone:954-599-4620
Mailing Address - Fax:
Practice Address - Street 1:6320 MIRAMAR PKWY
Practice Address - Street 2:STE F
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-3999
Practice Address - Country:US
Practice Address - Phone:954-599-4620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-11
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL66942225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty