Provider Demographics
NPI:1881605095
Name:START THERAPY INC
Entity type:Organization
Organization Name:START THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ISAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOU-MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:786-488-6978
Mailing Address - Street 1:1176 PEREGRINE WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2368
Mailing Address - Country:US
Mailing Address - Phone:786-488-6978
Mailing Address - Fax:305-698-6038
Practice Address - Street 1:1176 PEREGRINE WAY
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-2368
Practice Address - Country:US
Practice Address - Phone:786-488-6978
Practice Address - Fax:305-698-6038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3177225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5427Medicare ID - Type UnspecifiedMEDICARE PART B - GROUP