Therapy Source Solutions,LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT20357 Issued in FL

Legal business name

THERAPY SOURCE SOLUTIONS,LLC

Practice address

1917 Dan CT NE
Palm Bay, FL 32905-3044

Phone

(321) 724-2911

NPI assigned

Jun 2, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Rollanda Fayette McCoy, DPT

Title

President

Phone

(321) 724-2911

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1689968158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 DAN CT NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053044",
            "telephone_number": "321-724-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 DAN CT NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053044",
            "telephone_number": "321-724-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY SOURCE SOLUTIONS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "ROLLANDA",
        "authorized_official_middle_name": "FAYETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-724-2911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Palm Bay, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.