Provider Demographics
NPI:1457529968
Name:PEDIATRIC THERAPY NETWORK, P.A.
Entity type:Organization
Organization Name:PEDIATRIC THERAPY NETWORK, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:305-274-9966
Mailing Address - Street 1:9066 SW 73RD CT
Mailing Address - Street 2:UNIT 1809
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2964
Mailing Address - Country:US
Mailing Address - Phone:305-670-8045
Mailing Address - Fax:
Practice Address - Street 1:9830 SW 77TH AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2743
Practice Address - Country:US
Practice Address - Phone:305-274-9966
Practice Address - Fax:305-274-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12194225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1073562278OtherINDIVIDUAL NPI