Healthcare Provider Details

I. General information

NPI: 1740044478
Provider Name (Legal Business Name): OSCAR OSIEL CIFUENTES PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 S DIXIE HWY STE 100
MIAMI FL
33133-2462
US

IV. Provider business mailing address

1793 SW 5TH ST APT 302
MIAMI FL
33135-3517
US

V. Phone/Fax

Practice location:
  • Phone: 305-860-6383
  • Fax: 305-860-6526
Mailing address:
  • Phone: 786-231-9520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTT41356
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: