Provider Demographics
NPI:1013254267
Name:FUNCTIONAL INDEPENDENCE TRAINING CORP.
Entity Type:Organization
Organization Name:FUNCTIONAL INDEPENDENCE TRAINING CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-443-3646
Mailing Address - Street 1:3182 BATTERSEA WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-8136
Mailing Address - Country:US
Mailing Address - Phone:407-443-3646
Mailing Address - Fax:
Practice Address - Street 1:3182 BATTERSEA WAY
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-8136
Practice Address - Country:US
Practice Address - Phone:407-443-3646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty