Provider Demographics
NPI:1801214929
Name:THERAPY FOR U
Entity Type:Organization
Organization Name:THERAPY FOR U
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:LILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-712-7732
Mailing Address - Street 1:15056 SW 113TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2594
Mailing Address - Country:US
Mailing Address - Phone:786-712-7732
Mailing Address - Fax:
Practice Address - Street 1:15056 SW 113TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-2594
Practice Address - Country:US
Practice Address - Phone:786-712-7732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-04
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 12772235Z00000X
FLSA 12780235Z00000X
FLSA 12662235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007134600Medicaid
FL004306700Medicaid
FL007979300Medicaid