Healthcare Provider Details

I. General information

NPI: 1720704570
Provider Name (Legal Business Name): EARLY MOTION PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9520 SW 8TH ST APT 203
MIAMI FL
33174-3076
US

IV. Provider business mailing address

9520 SW 8TH ST APT 203
MIAMI FL
33174-3076
US

V. Phone/Fax

Practice location:
  • Phone: 305-978-1620
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH DIAZ GARCIA
Title or Position: OWNER
Credential:
Phone: 305-978-1620