Provider Demographics
NPI:1962198390
Name:PARADISE INMOTION THERAPY
Entity type:Organization
Organization Name:PARADISE INMOTION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LAUGOIS
Authorized Official - Last Name:MODERY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:941-726-4220
Mailing Address - Street 1:4837 SILVER TOPAZ ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2435
Mailing Address - Country:US
Mailing Address - Phone:941-726-4220
Mailing Address - Fax:
Practice Address - Street 1:4837 SILVER TOPAZ ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2435
Practice Address - Country:US
Practice Address - Phone:941-726-4220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
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