Provider Demographics
NPI:1194090068
Name:PAXXON HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:PAXXON HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-390-9880
Mailing Address - Street 1:10 NEW KING ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-1205
Mailing Address - Country:US
Mailing Address - Phone:914-390-9880
Mailing Address - Fax:914-390-9881
Practice Address - Street 1:5175 TAMIAMI TRL E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-4100
Practice Address - Country:US
Practice Address - Phone:239-963-4032
Practice Address - Fax:239-280-4002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty