Provider Demographics
NPI:1891985503
Name:SPECIALIZED THERAPY SERVICES INC.
Entity Type:Organization
Organization Name:SPECIALIZED THERAPY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:352-278-7220
Mailing Address - Street 1:471 FIRESTONE ST NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-2057
Mailing Address - Country:US
Mailing Address - Phone:321-206-8254
Mailing Address - Fax:866-337-2549
Practice Address - Street 1:20 E MELBOURNE AVE STE 103
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5970
Practice Address - Country:US
Practice Address - Phone:321-206-8254
Practice Address - Fax:866-337-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 11224261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation