Healthcare Provider Details

I. General information

NPI: 1093294803
Provider Name (Legal Business Name): PHYSICAL THERAPY NOW OF MANGONIA PARK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1748 45TH ST
WEST PALM BEACH FL
33407
US

IV. Provider business mailing address

1748 45TH ST
WEST PALM BEACH FL
33407
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDRES ZAPATA
Title or Position: C.E.O.
Credential:
Phone: 305-570-1666