Provider Demographics
NPI:1669767497
Name:FLORIDA HEALTH AND THERAPY, INC
Entity type:Organization
Organization Name:FLORIDA HEALTH AND THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:VIERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-454-1128
Mailing Address - Street 1:660 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4422
Mailing Address - Country:US
Mailing Address - Phone:954-454-1128
Mailing Address - Fax:954-944-3181
Practice Address - Street 1:660 E HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4422
Practice Address - Country:US
Practice Address - Phone:954-454-1128
Practice Address - Fax:954-944-3181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMC1245208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77027Medicaid
FL77027Medicaid