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General NPI Number Information
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NPI Number | 1033720354
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Entity Type | Organization
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Legal Business Name | ADVANCE CARE PHYSICAL THERAPY PC INC
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 4968 NW 106TH WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-2713
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Country | US
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Telephone | 347-255-8255
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Fax | 718-554-3034
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Provider Business Mailing Address
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Address Line | 4968 NW 106TH WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-2713
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Country | US
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Telephone | 347-255-8255
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Fax | 718-554-3034
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAFAEL MASTOV
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Credential | DPT
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Telephone | 347-255-8255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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