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General NPI Number Information
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NPI Number | 1043493083
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Entity Type | Organization
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Legal Business Name | HALLAK INCORPORATED
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 1125 NE 125 STREET SUITE 100
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City | N. MIAMI
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State | FL
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Zip | 33161-5014
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Country | US
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Telephone | 305-899-0266
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Fax | 305-895-0472
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Provider Business Mailing Address
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Address Line | 1125 NE 125 STREET SUITE 100
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City | N. MIAMI
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State | FL
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Zip | 33161-5014
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Country | US
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Telephone | 305-899-0266
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Fax | 305-895-0472
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS AYLEE A HALLAK
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Credential | M.PT.
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Telephone | 305-899-0266
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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 | PT21970
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License Number State | FL
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