Provider Demographics
NPI:1174288161
Name:THERAPY AND FITNESS BY LINDA, INC
Entity type:Organization
Organization Name:THERAPY AND FITNESS BY LINDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL /HAND THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMICIKLAS
Authorized Official - Suffix:
Authorized Official - Credentials:OTL, CHT
Authorized Official - Phone:561-504-3204
Mailing Address - Street 1:898 SW 14TH DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-6902
Mailing Address - Country:US
Mailing Address - Phone:561-504-3204
Mailing Address - Fax:
Practice Address - Street 1:898 SW 14TH DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-6902
Practice Address - Country:US
Practice Address - Phone:561-504-3204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty