Provider Demographics
NPI:1356574164
Name:THERAPEUTIC PRESENCE INC.
Entity type:Organization
Organization Name:THERAPEUTIC PRESENCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:954-648-3977
Mailing Address - Street 1:12355 NW 11TH CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4385
Mailing Address - Country:US
Mailing Address - Phone:954-648-3977
Mailing Address - Fax:
Practice Address - Street 1:11270 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4101
Practice Address - Country:US
Practice Address - Phone:954-441-7246
Practice Address - Fax:954-441-7241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24946251E00000X, 225100000X
FL43135225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFC296ZMedicare PIN