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General NPI Number Information
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NPI Number | 1114216470
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Entity Type | Organization
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Legal Business Name | PACE PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 04/06/2011
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 3306 PONCE DE LEON BLVD STE 200
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City | CORAL GABLES
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State | FL
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Zip | 33134-7286
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Country | US
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Telephone | 786-514-6316
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Fax | 786-221-4970
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Provider Business Mailing Address
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Address Line | 2510 LINCOLN AVE
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City | MIAMI
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State | FL
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Zip | 33133-3821
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Country | US
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Telephone | 786-514-6316
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Fax | 786-221-4970
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARIA JULIA L. PACE
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Credential | M.S.P.T
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Telephone | 786-514-6316
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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 | PT16930
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License Number State | FL
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