Healthcare Provider Details
I. General information
NPI: 1225467285
Provider Name (Legal Business Name): WEST KENDALL PHYSICAL THERAPY & HAND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2013
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13550 SW 88TH ST STE 110
MIAMI FL
33186-1654
US
IV. Provider business mailing address
13550 SW 88TH ST STE 110
MIAMI FL
33186-1654
US
V. Phone/Fax
- Phone: 305-408-7353
- Fax: 305-408-7355
- Phone: 305-408-7353
- Fax: 305-408-7355
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | HCC 7047 |
| License Number State | FL |
VIII. Authorized Official
Name:
RANDALL
BROWNING
Title or Position: PRESIDENT
Credential: RN BSN PTA
Phone: 305-408-7353