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General NPI Number Information
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NPI Number | 1104208032
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Entity Type | Organization
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Legal Business Name | MIAMI GARDENS PHYSICAL THERAPY AND REHAB CENTER, LLC
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Dates
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Enumeration Date | 06/27/2015
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 2259 NW 167TH ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4638
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Country | US
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Telephone | 786-318-8470
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Fax |
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Provider Business Mailing Address
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Address Line | 2259 NW 167TH ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4638
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Country | US
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Telephone | 786-318-8470
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MS. SHALAINE MURRAY
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Credential |
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Telephone | 305-952-3139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT4649
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License Number State | FL
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