Provider Demographics
NPI:1295165066
Name:IN HOME THERAPY OF MONROE COUNTY
Entity type:Organization
Organization Name:IN HOME THERAPY OF MONROE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:305-481-5180
Mailing Address - Street 1:144 S BAHAMA DR
Mailing Address - Street 2:
Mailing Address - City:DUCK KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33050-3714
Mailing Address - Country:US
Mailing Address - Phone:305-481-5180
Mailing Address - Fax:305-357-6305
Practice Address - Street 1:144 S BAHAMA DR
Practice Address - Street 2:
Practice Address - City:DUCK KEY
Practice Address - State:FL
Practice Address - Zip Code:33050-3714
Practice Address - Country:US
Practice Address - Phone:305-481-5180
Practice Address - Fax:305-357-6305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9741225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1174649503OtherNPI INDIVIDUAL LEVEL 1