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General NPI Number Information
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NPI Number | 1184040370
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Entity Type | Organization
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Legal Business Name | GOODREACH MEDICAL SERVICES INC
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Dates
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Enumeration Date | 03/12/2014
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 12905 SW 42ND ST STE 201
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City | MIAMI
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State | FL
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Zip | 33175-2912
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Country | US
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Telephone | 786-277-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 12905 SW 42ND ST STE 201
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City | MIAMI
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State | FL
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Zip | 33175-2912
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Country | US
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Telephone | 786-277-6300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YOSDANIS MENENDEZ
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Credential |
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Telephone | 786-277-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | PT17879
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License Number State | FL
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