Provider Demographics
NPI:1457869943
Name:RESTORE THERAPY SERVICES OF FLORIDA LLC
Entity Type:Organization
Organization Name:RESTORE THERAPY SERVICES OF FLORIDA LLC
Other - Org Name:RESTORE THERAPY SERVICES OF FLORIDA LECANTO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:KNOWLES
Authorized Official - Last Name:CULPEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-941-6820
Mailing Address - Street 1:245 CAHABA VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2216
Mailing Address - Country:US
Mailing Address - Phone:205-942-6820
Mailing Address - Fax:
Practice Address - Street 1:4865 W GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-8168
Practice Address - Country:US
Practice Address - Phone:352-746-5483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTORE THERAPY SERVICES OF FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-18
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty