Provider Demographics
NPI:1700243995
Name:FURTHERING INDEPENDENCE WITH THERAPY
Entity Type:Organization
Organization Name:FURTHERING INDEPENDENCE WITH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ-ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:305-321-7169
Mailing Address - Street 1:PO BOX 343191
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33034-0191
Mailing Address - Country:US
Mailing Address - Phone:305-321-7169
Mailing Address - Fax:
Practice Address - Street 1:1781 NW 3RD AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-3164
Practice Address - Country:US
Practice Address - Phone:305-321-7169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty