Healthcare Provider Details

I. General information

NPI: 1992433841
Provider Name (Legal Business Name): NEW MILLENNIUM PHYSICAL THERAPY & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 W SR 436 STE 1017
ALTAMONTE SPRINGS FL
32714-3055
US

IV. Provider business mailing address

851 W SR 436 STE 1017
ALTAMONTE SPRINGS FL
32714-3055
US

V. Phone/Fax

Practice location:
  • Phone: 407-637-2650
  • Fax: 321-972-4919
Mailing address:
  • Phone: 407-637-2650
  • Fax: 321-972-4919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. USBER ARLEX JURI
Title or Position: THERAPIST/OWNER
Credential: PTA
Phone: 561-598-1370