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General NPI Number Information
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NPI Number | 1215493200
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Entity Type | Organization
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Legal Business Name | GRAND PHYSICAL THERAPY CO
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 5200 SW 8TH ST STE 202B
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City | CORAL GABLES
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State | FL
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Zip | 33134-2337
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Country | US
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Telephone | 786-901-1236
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Fax | 786-364-0217
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Provider Business Mailing Address
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Address Line | 6773 S WATERWAY DR
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City | MIAMI
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State | FL
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Zip | 33155-3743
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Country | US
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Telephone | 786-901-1236
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Fax | 786-364-0217
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Authorized Official
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Title or Position | CEO
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Name | MURIEL EMILCE GONZALEZ GRANDOLI
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Credential | MPT
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Telephone | 786-901-1236
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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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