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General NPI Number Information
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NPI Number | 1184921967
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Entity Type | Organization
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Legal Business Name | MAGIC THERAPY CENTER INC.
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Dates
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Enumeration Date | 02/14/2011
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 5755 W FLAGLER ST 205
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City | MIAMI
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State | FL
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Zip | 33144-3441
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Country | US
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Telephone | 305-267-5213
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Fax | 305-267-5313
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Provider Business Mailing Address
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Address Line | 5755 W FLAGLER ST 205
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City | MIAMI
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State | FL
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Zip | 33144-3441
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Country | US
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Telephone | 305-267-5213
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Fax | 305-267-5313
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Authorized Official
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Title or Position | CEO
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Name | YURIEN GONZALEZ- YANEZ
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Credential | MT
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Telephone | 305-267-5213
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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 |
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License Number State |
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