Aegis Group Practice, LLC
Organization Active NPI Occupational Therapist · Hollywood, FL
NPI 1740720002 · NPPES record last updated Mar 6, 2017
Key facts
- NPI
- 1740720002
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Occupational Therapist 225X00000X
- Legal business name
- AEGIS GROUP PRACTICE, LLC
- Practice address
- 2580 Pine Island Rd
Hollywood, FL 33024-8582 - Phone
- (479) 201-2000
- Fax
- (479) 201-4801
- NPI assigned
- Mar 6, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- AEGIS THERAPIES, INC.
Authorized official
- Name
- Mike McOlvin
- Title
- Director
- Phone
- (479) 201-2000
Other NPIs on the same Medicare enrollment 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170720002185 | FL | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 17 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Indian Harbour Beach, FL; Pensacola, FL |
National Provider Directory
- Part of
- Aegis
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | Yes | ||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
2580 Pine Island Rd
Hollywood, FL 33024-8582
Mailing address
1000 Fianna Way # Md4843
Fort Smith, AR 72919-9008
Phone (479) 201-2000
Other providers in Hollywood, FL
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- Sarah Aeder
- Aegis Group Practice LLC
- Aesthetic Medical Academy USA Inc
- Afc Medical Devices LLC
- Mesfin Afework
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All providers in Hollywood, FL · Occupational Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.