Provider Demographics
NPI:1831326149
Name:BACK TO FUNCTION INC
Entity type:Organization
Organization Name:BACK TO FUNCTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALTES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L MHSC
Authorized Official - Phone:786-553-0104
Mailing Address - Street 1:2640 SW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2211
Mailing Address - Country:US
Mailing Address - Phone:786-553-0104
Mailing Address - Fax:
Practice Address - Street 1:2640 SW 25TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2211
Practice Address - Country:US
Practice Address - Phone:786-553-0104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 10913225100000X
FLOT 6399225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty