Provider Demographics
NPI:1851621833
Name:THERAPIST ON THE GO LLC
Entity Type:Organization
Organization Name:THERAPIST ON THE GO LLC
Other - Org Name:WINTER PARK PHYSICAL THERAPY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TESSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARBALLO SCHARF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:714-580-4304
Mailing Address - Street 1:5367 PENWAY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6716
Mailing Address - Country:US
Mailing Address - Phone:714-580-4304
Mailing Address - Fax:407-629-8600
Practice Address - Street 1:2301 LEE RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1749
Practice Address - Country:US
Practice Address - Phone:714-580-4304
Practice Address - Fax:407-629-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty