MEDICARE: MIAMI PHYSICAL THERAPY ASSOCIATES INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y914X	OTHER	FL	BCBS OF FL PROVIDER ID

General Provider Information

NPI Number	:	1548205321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI PHYSICAL THERAPY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	2931 CORAL WAY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3205
Country	:	US
Telephone Number	:	305-444-0074
Fax Number	:	305-444-8503

Provider Business Practice Location Address
First Line	:	2931 CORAL WAY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3205
Country	:	US
Telephone Number	:	305-444-0074
Fax Number	:	305-444-8503

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MIRIAM M GUANCHE
Credential	:	P.T.
Telephone Number	:	305-444-0074

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	03/11/2020

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