Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mobile Lymphedema Clinic LLC

Organization Rehabilitation Practitioner · NPI 1104706837

Mobile Lymphedema Clinic LLC is a Rehabilitation Practitioner in Fort Walton Beach, Florida. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
7
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

804 Pine Alley St
Fort Walton Beach, FL 32547-1216
Phone: (850) 803-6683
Fax: (888) 857-4412
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X
Rehabilitation Practitioner Taxonomy 225400000X
Environmental Modification Occupational Therapist Taxonomy 225XE0001X
Ergonomics Occupational Therapist Taxonomy 225XE1200X
Gerontology Occupational Therapist Taxonomy 225XG0600X
Hand Occupational Therapist Taxonomy 225XH1200X
Physical Rehabilitation Occupational Therapist Taxonomy 225XP0019X

Record details

NPI number1104706837
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jessica Boothe — Owner, Clinician · (850) 217-2186
Other names Move Me Lymphatics-Mobile Lymphedema Clinic
NPI enumeratedSeptember 4, 2025
Last updated in NPPESFebruary 18, 2026
Certification dateFebruary 18, 2026
Mailing address804 Pine Alley St, Fort Walton Beach, FL 32547-1216

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