Provider Demographics
NPI:1821285941
Name:ACCESS HOMETHERAPY INC
Entity Type:Organization
Organization Name:ACCESS HOMETHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-777-0342
Mailing Address - Street 1:4000 PONCE DE LEON BLVD
Mailing Address - Street 2:#470
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1431
Mailing Address - Country:US
Mailing Address - Phone:305-777-0342
Mailing Address - Fax:866-816-9797
Practice Address - Street 1:4000 PONCE DE LEON BLVD
Practice Address - Street 2:#470
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1431
Practice Address - Country:US
Practice Address - Phone:305-777-0342
Practice Address - Fax:866-816-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 10370225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4748Medicare UPIN
FLU1448-AMedicare UPIN