Healthcare Provider Details

I. General information

NPI: 1154815926
Provider Name (Legal Business Name): USA SPORTS THERAPY SOUTH MIAMI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 PONCE DE LEON BLVD STE 302
CORAL GABLES FL
33134-5418
US

IV. Provider business mailing address

21150 BISCAYNE BLVD STE 406
AVENTURA FL
33180-1250
US

V. Phone/Fax

Practice location:
  • Phone: 305-935-9599
  • Fax:
Mailing address:
  • Phone: 305-935-9599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. MATTHEW COPPER
Title or Position: AO/ OWNER/ PROVIDER
Credential: DC
Phone: 305-935-9599