MEDICARE: MIAMI PHYSICAL THERAPY GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	15156	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316090996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI PHYSICAL THERAPY GROUP

Provider Business Mailing Address
First Line	:	8020 SW 36TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-3454
Country	:	US
Telephone Number	:	305-978-3319
Fax Number	:	305-854-5887

Provider Business Practice Location Address
First Line	:	1797 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-2728
Country	:	US
Telephone Number	:	305-978-3310
Fax Number	:	305-854-5887

Authorized Official
Title or Position	:	DIRECTOR OF REHAB
Name	:	MRS. LANIA GARCIA
Credential	:	PT
Telephone Number	:	305-978-3310

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	08/22/2020

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