Healthcare Provider Details

I. General information

NPI: 1407326630
Provider Name (Legal Business Name): REGION THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2018
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 W 47TH PL STE 306
HIALEAH FL
33012-3447
US

IV. Provider business mailing address

1275 W 47TH PL STE 305
HIALEAH FL
33012-3447
US

V. Phone/Fax

Practice location:
  • Phone: 786-399-0683
  • Fax: 305-238-7233
Mailing address:
  • Phone: 786-399-0683
  • Fax: 305-238-7233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DENNIS MARZO
Title or Position: PRESIDENT
Credential:
Phone: 786-399-0683