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General NPI Number Information
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NPI Number | 1073985461
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Entity Type | Individual
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Provider Name | JONATHAN GIL CTRS
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Gender | Male
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Dates
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Enumeration Date | 10/23/2015
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Last Update Date | 09/07/2019
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Provider Practice Location Address
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Address Line | 19221 NE 10TH AVE
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179
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Country | US
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Telephone | 954-599-4620
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Fax |
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Provider Business Mailing Address
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Address Line | 21 NW 1ST AVE UNIT 202
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City | DANIA BEACH
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State | FL
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Zip | 33004-1441
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Country | US
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Telephone | 954-599-4620
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State | FL
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