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METAMORPHOSIS THERAPY LLC NPI 1942519103


NPI Information

NPI: 1942519103
Provider Name: METAMORPHOSIS THERAPY, LLC
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization
Address:
301 S TUBB ST STE A-1
OAKLAND, FL
ZIP 34760
Phone: (407) 395-9976
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METAMORPHOSIS THERAPY, LLC is a speech language pathologist in Oakland, FL. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. METAMORPHOSIS THERAPY, LLC NPI is 1942519103. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

301 S TUBB ST STE A-1
OAKLAND, FL
ZIP 34760
Phone: (407) 395-9976
Fax: (407) 992-9368

The provider's authorized official is Bridgett Elaine Dimant .
The authorized official title is Speech Language Pathologist and has the following contact phone number (407) 285-7907.

The enumeration date for this NPI number is 10/5/2010 and was last updated on 6/29/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103K00000XBehavior Analyst017434700FLORIDANo
2225100000XPhysical TherapistNo
32251P0200XPhysical TherapistPediatricsNo
4225X00000XOccupational TherapistNo
5225XF0002XOccupational TherapistFeeding, Eating & SwallowingNo
6252Y00000XEarly Intervention Provider AgencyNo
7261QM1300XClinic/CenterMulti-SpecialtyNo
8235Z00000XSpeech-Language PathologistSA 9096FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1002986300MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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