Healthcare Provider Details

I. General information

NPI: 1508076860
Provider Name (Legal Business Name): WEST COAST THERAPY AND REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3899 NW 7 ST SUITE 200B
MIAMI FL
33126
US

IV. Provider business mailing address

3899 NW 7ST SUITE 200B
MIAMI FL
33126
US

V. Phone/Fax

Practice location:
  • Phone: 305-644-9600
  • Fax: 305-644-9605
Mailing address:
  • Phone: 305-644-9600
  • Fax: 305-644-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberHCC5962
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number StateFL

VIII. Authorized Official

Name: DENNIS FERRER GUILART
Title or Position: PRESIDENT
Credential:
Phone: 305-644-9600