1245721760 NPI number — PHYSICAL THERAPY NOW OF SOUTH FLORIDA LLC

Table of content: (NPI 1245721760)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245721760 NPI number — PHYSICAL THERAPY NOW OF SOUTH FLORIDA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHYSICAL THERAPY NOW OF SOUTH FLORIDA LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245721760
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15680 SW 88TH ST STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33196-1160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-570-1666
Provider Business Mailing Address Fax Number:
305-203-0546

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3595 WEST 20 AVE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-244-5883
Provider Business Practice Location Address Fax Number:
305-203-0546
Provider Enumeration Date:
05/21/2018

Additional Information

Authorized Official

Authorized Official Last Name:
ZAPATA
Authorized Official First Name:
ANDRES
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
305-570-1666

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  OT11471 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: OT11471 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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