Provider Demographics
NPI:1194152439
Name:LIFE IN MOTION PHYSICAL & HAND THERAPY
Entity type:Organization
Organization Name:LIFE IN MOTION PHYSICAL & HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST / CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:DRIGGERS
Authorized Official - Last Name:RIVEROS
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:727-369-6355
Mailing Address - Street 1:9125 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-5406
Mailing Address - Country:US
Mailing Address - Phone:727-369-6355
Mailing Address - Fax:727-362-4766
Practice Address - Street 1:9125 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-5406
Practice Address - Country:US
Practice Address - Phone:727-369-6355
Practice Address - Fax:727-362-4766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7006350001OtherMEDICARE DME PTAN
FLHR981AOtherMEDICARE PTAN