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General NPI Number Information
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NPI Number | 1154560514
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Entity Type | Organization
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Legal Business Name | M. G. A. MASSAGES REHABILITATION CENTER
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 02/09/2009
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Provider Practice Location Address
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Address Line | 3383 NW 7TH ST SUITE 206
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City | MIAMI
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State | FL
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Zip | 33125-4140
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Country | US
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Telephone | 305-646-6760
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Fax | 305-646-6761
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Provider Business Mailing Address
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Address Line | 3383 NW 7TH ST SUITE 206
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City | MIAMI
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State | FL
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Zip | 33125-4140
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Country | US
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Telephone | 305-646-6760
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Fax | 305-646-6761
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. OLGA GONZALEZ
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Credential |
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Telephone | 305-646-6760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | HCC7015
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License Number State | FL
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