NPIMap

Organization Active NPI

Dynamic Pediatric Therapy, Inc.

  • Contractor
  • Homestead, FL
National Provider Identifier
1083916787
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
OTA11461 Issued in FL
Legal business name
DYNAMIC PEDIATRIC THERAPY, INC.
Practice address
15600 SW 288TH St Ste 202
Homestead, FL 33033-1200
Phone
(305) 242-9424
NPI assigned
Dec 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ileana MartinezNPI 1275787566
Title
President
Phone
(305) 242-9424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193200000X MULTI-SPECIALTY GROUP 171W00000X OTA11461 FL Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

15600 SW 288TH St Ste 202
Homestead, FL 33033-1200

Mailing address

3581 NE 11 Dr
None
Homestead, FL 33033
Phone (954) 682-7633

Other practice location 1

14400 NW 77 CT Suite 100
Miami Lakes, FL 33016
Phone (305) 242-9424

Other identifiers 1

IdentifierTypeStateIssuer
001392900MedicaidFL

Other names 1

  • Dynamic Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1083916787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3581 NE 11 DR",
            "address_2": "NONE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "33033",
            "telephone_number": "954-682-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 SW 288TH ST STE 202",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330331200",
            "telephone_number": "305-242-9424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14400 NW 77 CT Suite 100",
            "address_purpose": "LOCATION",
            "city": "Miami Lakes",
            "state": "FL",
            "postal_code": "33016",
            "country_code": "US",
            "telephone_number": "305-242-9424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DYNAMIC PEDIATRIC THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ILEANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-242-9424"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": "FL",
            "license": "OTA11461",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001392900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dynamic Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.