Healthcare Provider Details

I. General information

NPI: 1437650850
Provider Name (Legal Business Name): PHYSICAL THERAPY NOW COUNTRY WALK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13717 SW 152ND ST
MIAMI FL
33177-1106
US

IV. Provider business mailing address

13717 SW 152ND ST
MIAMI FL
33177-1106
US

V. Phone/Fax

Practice location:
  • Phone: 305-570-1666
  • Fax: 305-203-0546
Mailing address:
  • Phone: 305-570-1666
  • Fax: 305-203-0546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberOT11471
License Number StateFL

VIII. Authorized Official

Name: MR. ANDRES ZAPATA
Title or Position: MANAGER
Credential: OT
Phone: 305-244-5883