Healthcare Provider Details

I. General information

NPI: 1417396433
Provider Name (Legal Business Name): S&M PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 04/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 FONTAINEBLEAU BLVD SUITE 2K4
MIAMI FL
33172-7018
US

IV. Provider business mailing address

175 FONTAINEBLEAU BLVD SUITE 2K4
MIAMI FL
33172-7018
US

V. Phone/Fax

Practice location:
  • Phone: 786-614-2413
  • Fax: 786-614-2413
Mailing address:
  • Phone: 786-614-2413
  • Fax: 786-614-2413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License NumberMA62692
License Number StateFL

VIII. Authorized Official

Name: SANTIAGO ARAP
Title or Position: PRESIDENT
Credential:
Phone: 786-614-2413