Healthcare Provider Details

I. General information

NPI: 1487545786
Provider Name (Legal Business Name): EMS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6704 CHIPPEWA DR
BALTIMORE MD
21209-1514
US

IV. Provider business mailing address

20200 W DIXIE HWY STE 902 SUITE 902 #1087
AVENTURA FL
33180-1926
US

V. Phone/Fax

Practice location:
  • Phone: 305-492-8388
  • Fax:
Mailing address:
  • Phone: 305-492-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: NATE SHALEM
Title or Position: OWNER
Credential: DPT
Phone: 305-492-8388