Healthcare Provider Details
I. General information
NPI: 1518309772
Provider Name (Legal Business Name): SYMMETRY PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2013
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
28 W FLAGLER ST STE 901
MIAMI FL
33130-1894
US
IV. Provider business mailing address
3590 CORAL WAY APT 707
MIAMI FL
33145-3076
US
V. Phone/Fax
- Phone: 815-814-8444
- Fax:
- Phone: 815-814-8444
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
NATALIA
SOPHIA
SIKACZOWSKI
Title or Position: OWNER
Credential: DPT
Phone: 815-814-8444