Healthcare Provider Details

I. General information

NPI: 1497786610
Provider Name (Legal Business Name): M&T THERAPIST ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 NW 62ND AVE SUITE # 210
MIAMI GARDENS FL
33015-8200
US

IV. Provider business mailing address

18300 NW 62ND AVE SUITE # 210
MIAMI GARDENS FL
33015-8200
US

V. Phone/Fax

Practice location:
  • Phone: 305-474-4960
  • Fax: 305-474-4962
Mailing address:
  • Phone: 305-474-4960
  • Fax: 305-474-4962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA4558
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT8915
License Number StateFL

VIII. Authorized Official

Name: MR. EDUARDO A QUIROGA
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-474-4960