Provider Demographics
NPI:1952074007
Name:THERAPEDZ THERAPIST UNLIMITED, LLC
Entity Type:Organization
Organization Name:THERAPEDZ THERAPIST UNLIMITED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:OCCUPATIONAL THERAPY
Authorized Official - Phone:904-200-2712
Mailing Address - Street 1:14574 DURBIN ISLAND WAY
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-7094
Mailing Address - Country:US
Mailing Address - Phone:904-200-2712
Mailing Address - Fax:
Practice Address - Street 1:14574 DURBIN ISLAND WAY
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-7094
Practice Address - Country:US
Practice Address - Phone:904-200-2712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty