Provider Demographics
| NPI: | 1992513246 |
|---|---|
| Name: | MUNDI TRAVEL THERAPY AND STAFFING LLC |
| Entity type: | Organization |
| Organization Name: | MUNDI TRAVEL THERAPY AND STAFFING LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CO-OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JOHN |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | IMUNDI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | PT |
| Authorized Official - Phone: | 516-581-0838 |
| Mailing Address - Street 1: | 2207 E TAHITIAN WAY |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GILBERT |
| Mailing Address - State: | AZ |
| Mailing Address - Zip Code: | 85234-2867 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 516-581-0838 |
| Mailing Address - Fax: | 516-581-0838 |
| Practice Address - Street 1: | 2207 E TAHITIAN WAY |
| Practice Address - Street 2: | |
| Practice Address - City: | GILBERT |
| Practice Address - State: | AZ |
| Practice Address - Zip Code: | 85234-2867 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 516-581-0838 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-12-19 |
| Last Update Date: | 2024-12-19 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
| No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Multi-Specialty | |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 227800000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Group - Multi-Specialty | |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |
