Provider Demographics
NPI:1194559781
Name:SUNCOAST MOBILE WELLNESS AND THERAPY LLC
Entity type:Organization
Organization Name:SUNCOAST MOBILE WELLNESS AND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:651-206-8349
Mailing Address - Street 1:11812 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-3430
Mailing Address - Country:US
Mailing Address - Phone:651-206-8349
Mailing Address - Fax:
Practice Address - Street 1:11812 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-3430
Practice Address - Country:US
Practice Address - Phone:651-206-8349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty