EASTER SEALS - NPI 1376631747 - Physical Therapist in Daytona Beach, FL

Q: What is Easterseals Northeast Central Florida's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Pediatrics, with taxonomy code 2251P0200X.

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About Easter Seals NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTER SEALS (NPI 1376631747) is a healthcare organization registered as a pediatrics in Daytona Beach, Florida and active in the NPI registry since October 2006. The organization lists Beverly Johnson, Ceo (president), as its authorized official.

NPPES Registry Identity

NPI1376631747

Entity TypeOrganization

Primary Taxonomy2251P0200X

Legal Business NameEASTERSEALS NORTHEAST CENTRAL FLORIDA

Location Address1219 DUNN AVEDaytona Beach, FL 32114

Mailing Address1219 Dunn AveDaytona Beach, FL 32114-2405 · (386) 255-4568 · Fax (386) 258-7677

Phone(386) 255-4568

Fax(386) 258-7677

Organization SubpartNo

Authorized OfficialBeverly JohnsonCeo (president) · (386) 255-4568

Enumeration DateOctober 11, 2006

Last NPPES UpdateMay 29, 2018

✔ NPI 1376631747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · PediatricsRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251P0200X

License✔ Licensed in FL · PT 14797

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.

1219 DUNN AVE, Daytona Beach, FL 32114

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Other Names 1

Doing Business AsEaster Seals

Other Identifiers 1

Medicaid883828300FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARISSA MARTORAL

Physical Therapist