Healthcare Provider Details

I. General information

NPI: 1518939412
Provider Name (Legal Business Name): ANC PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4615 NW 72ND AVE STE 115
MIAMI FL
33166-5689
US

IV. Provider business mailing address

4615 NW 72ND AVE STE 115
MIAMI FL
33166-5689
US

V. Phone/Fax

Practice location:
  • Phone: 305-591-3284
  • Fax: 305-594-3093
Mailing address:
  • Phone: 305-591-3284
  • Fax: 305-594-3093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARIDAD VELAZQUEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-591-3284