Provider Demographics
NPI:1891315537
Name:ORLANDO IN HOME THERAPY GROUP, LLC
Entity Type:Organization
Organization Name:ORLANDO IN HOME THERAPY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIA
Authorized Official - Middle Name:
Authorized Official - Last Name:QIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-409-8811
Mailing Address - Street 1:165 ROSETTE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-7123
Mailing Address - Country:US
Mailing Address - Phone:407-409-8811
Mailing Address - Fax:321-765-5963
Practice Address - Street 1:165 ROSETTE DR
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-7123
Practice Address - Country:US
Practice Address - Phone:407-409-8811
Practice Address - Fax:321-765-5963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty