| Organization Name: | SUPREME THERAPY, LLC |
| NPI Number: | 1225143647 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOANNES MARIA CLAESSENS (MANAGING MEMBER) |
| Mailing Address: | 770 Keeneland Pike Lake Mary |
| State: | FL US |
| Postal Code: | 327463951 |
| Phone Number: | 4073218833 |
| Fax Number: | 4073229966 |
| NPI Enumeration Date: | 08/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT16865 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |