Healthcare Provider Details

I. General information

NPI: 1336166313
Provider Name (Legal Business Name): MONICA LINK PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7911 NW 72ND AVE SUITE 204
MEDLEY FL
33166-2227
US

IV. Provider business mailing address

21205 NE 37TH AVE
AVENTURA FL
33180-4051
US

V. Phone/Fax

Practice location:
  • Phone: 305-883-6180
  • Fax: 305-883-6301
Mailing address:
  • Phone: 305-692-4435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT1228
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: