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General NPI Number Information
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NPI Number | 1073118006
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Entity Type | Organization
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Legal Business Name | I HEART THEARPY LLC
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 4610 N UNIVERSITY DRIVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33067
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Country | US
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Telephone | 561-306-2998
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Fax |
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Provider Business Mailing Address
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Address Line | 5379 LYONS RD # 106
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City | COCONUT CREEK
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State | FL
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Zip | 33073-2810
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL PAWELEK
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Credential |
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Telephone | 561-306-2998
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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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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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