Provider Demographics
NPI:1487794665
Name:LIMA THERAPY GROUP OF BROWARD
Entity type:Organization
Organization Name:LIMA THERAPY GROUP OF BROWARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-984-2701
Mailing Address - Street 1:5651 NW 29TH ST
Mailing Address - Street 2:SUIT A
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-1531
Mailing Address - Country:US
Mailing Address - Phone:954-984-2701
Mailing Address - Fax:
Practice Address - Street 1:5651 NW 29TH ST
Practice Address - Street 2:SUIT A
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-1531
Practice Address - Country:US
Practice Address - Phone:954-984-2701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X, 224Z00000X, 225100000X, 225200000X, 225X00000X, 2355S0801X
FLSA4861235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL811878700Medicaid
FL891856200Medicaid