Provider Demographics
NPI:1356228761
Name:LYMPHEDEMA SPECIALISTS LLC
Entity type:Organization
Organization Name:LYMPHEDEMA SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:W
Authorized Official - Last Name:PEPE
Authorized Official - Suffix:
Authorized Official - Credentials:OT, CHT, CLT
Authorized Official - Phone:727-377-2129
Mailing Address - Street 1:4896 SILVERTHORNE CT
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-6326
Mailing Address - Country:US
Mailing Address - Phone:203-578-0336
Mailing Address - Fax:
Practice Address - Street 1:30669 US HIGHWAY 19 N STE 409
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-4410
Practice Address - Country:US
Practice Address - Phone:727-377-2129
Practice Address - Fax:813-967-8524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty