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General NPI Number Information
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NPI Number | 1124225958
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Entity Type | Organization
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Legal Business Name | ULTRA THERAPY CARE CENTER, CORP.
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5854 W 20TH AVE
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City | HIALEAH
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State | FL
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Zip | 33016-2603
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Country | US
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Telephone | 786-507-4218
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Fax |
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Provider Business Mailing Address
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Address Line | 5854 W 20TH AVE
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City | HIALEAH
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State | FL
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Zip | 33016-2603
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Country | US
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Telephone | 786-507-4218
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEJANDRO OSCAR NALDA
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Credential | D.C.
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Telephone | 786-507-4218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 6057160
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License Number State | FL
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