Provider Demographics
NPI:1427140094
Name:SPHINX WELLNESS INC
Entity type:Organization
Organization Name:SPHINX WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ONSI
Authorized Official - Middle Name:N
Authorized Official - Last Name:DERIAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:352-307-6843
Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32158-1568
Mailing Address - Country:US
Mailing Address - Phone:352-307-6843
Mailing Address - Fax:352-307-9308
Practice Address - Street 1:10935 SE 177TH PL
Practice Address - Street 2:SUITE 406
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8975
Practice Address - Country:US
Practice Address - Phone:352-307-6843
Practice Address - Fax:352-307-9308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2015-12-01
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8906394Medicaid
FLDE2685Medicare PIN
FLK6287Medicare PIN