Providence Pediatric Therapy

LBN: Providence Pediatric Therapy
Providence Pediatric Therapy is an health care organization with primary practice located at 7616 W Courtney Campbell Cswy Unit 210 , Tampa FL 33607-1533. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as the primary health care specialty. Providence Pediatric Therapy can be contacted via phone (815) 505-5545, or through Berge, Hannah Nicole via phone (815) 505-5545.

Contact Information

Primary practice address
7616 W Courtney Campbell Cswy Unit 210 Tampa FL 33607-1533
Phone: (815) 505-5545
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Berge, Hannah Nicole OTR/L
Phone: (815) 505-5545

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X

Profile Details

NPI number 1477132579
LBN Legal business name Providence Pediatric Therapy
DBA Doing business as
Authorized official Berge, Hannah Nicole OTR/L
Entity Organization
Organization subpart 1 No
Enumeration date Apr 6th, 2021
Last updated Apr 6th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477132579 NPPES
Florida MEDICAID OT20551

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