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General NPI Number Information
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NPI Number | 1033581194
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Entity Type | Organization
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Legal Business Name | TOTAL FUNCTIONAL REHABILITATION THERAPY,
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 104 CRANDON BLVD STE 421C
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City | KEY BISCAYNE
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State | FL
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Zip | 33149-1407
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Country | US
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Telephone | 305-613-1966
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Fax | 305-365-1773
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Provider Business Mailing Address
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Address Line | 575 CRANDON BLVD APT 609
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City | KEY BISCAYNE
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State | FL
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Zip | 33149-1864
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Country | US
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Telephone | 305-613-1966
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL ALEJANDRO WALDMAN
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Credential | PT
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Telephone | 305-613-1966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT20915
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License Number State | FL
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