Provider Demographics
NPI:1942504600
Name:CHRISTINA LOVERA OTR/L, INC.
Entity Type:Organization
Organization Name:CHRISTINA LOVERA OTR/L, INC.
Other - Org Name:PALM PEDIATRIC THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LOVERA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:561-694-7661
Mailing Address - Street 1:1546 CORBISON POINT PL
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5304
Mailing Address - Country:US
Mailing Address - Phone:561-694-7661
Mailing Address - Fax:561-694-7691
Practice Address - Street 1:11911 US HIGHWAY 1
Practice Address - Street 2:SUITE 102
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-2827
Practice Address - Country:US
Practice Address - Phone:561-694-7661
Practice Address - Fax:561-694-7691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12060225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891064200Medicaid