MEDICARE: LUXURY THERAPY MEDICAL CENTER CORP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2085U0001X	Diagnostic Ultrasound Physician
2	261QP2000X	Physical Therapy Clinic/Center
3	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1952044554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUXURY THERAPY MEDICAL CENTER CORP

Provider Business Mailing Address
First Line	:	1840 W 49TH ST STE 517
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2950
Country	:	US
Telephone Number	:	786-663-7276
Fax Number	:	305-397-2988

Provider Business Practice Location Address
First Line	:	1840 W 49TH ST STE 517
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2950
Country	:	US
Telephone Number	:	786-663-7276
Fax Number	:	305-397-2988

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YIDIER LAZO GIL
Credential	:	RMDS, RVT
Telephone Number	:	786-663-7276

Provider Enumeration Date	:	04/20/2022
Last Update Date	:	02/19/2026

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Directions to “LUXURY THERAPY MEDICAL CENTER CORP ” Practice Location

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