Functionality for Life, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

FUNCTIONALITY FOR LIFE, LLC

Practice address

1234 Katahdin CT
Wesley Chapel, FL 33543-6860

Phone

(813) 442-1204

NPI assigned

Oct 14, 2019

Organization subpart

No

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

Authorized official

Name

Jennifer Trevino, OTR/LNPI 1932644218

Title

Owner

Phone

(813) 442-1204

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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

• Jennifer Trevino, OTR/L

  • Occupational Therapist
  • Wesley Chapel, FL
  • NPI 1932644218
  Medicare reassignment Care Compare group NPD Authorized official
• Jody Rappaport, M PT

  • Specialist
  • Tampa, FL
  • NPI 1790841542
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1932741659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 KATAHDIN CT",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335436860",
            "telephone_number": "813-442-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 KATAHDIN CT",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335436860",
            "telephone_number": "813-442-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONALITY FOR LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-442-1204",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Human Factors",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Low Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Samataro Frisone, LMFT
• Robert John Fry, CRNA
• FSBS Enterprises, Inc.
• Johanna C Fuentes-Valdes, M.D.
• Kathryn Fultz
• Justine Marie Gabel, LMHC
• Randa Gad Elrab
• Brooke Galiszewski
• Joel Galvan, RN
• Prachi Gandhi

• Occupational Therapist in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.