Laser Focus Pediatric Therapy Center, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

LASER FOCUS PEDIATRIC THERAPY CENTER, LLC

Practice address

3409 NW 9TH Ave Ste 1104
Oakland Park, FL 33309-5945

Phone

(954) 835-5252

Fax

(954) 533-3898

NPI assigned

Mar 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. George Samuel, DC

Title

Head Clinician

Phone

(954) 834-5252

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1730764499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 NW 9TH AVE STE 1104",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333095945",
            "telephone_number": "954-835-5252",
            "fax_number": "954-533-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 NW 9TH AVE STE 1104",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333095945",
            "telephone_number": "954-835-5252",
            "fax_number": "954-533-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER FOCUS PEDIATRIC THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "HEAD CLINICIAN",
        "authorized_official_telephone_number": "954-834-5252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16267",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Oakland Park, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.