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General NPI Number Information
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NPI Number | 1255408852
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Entity Type | Organization
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Legal Business Name | ELLEN ALDERMAN RPT, INC
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 03/06/2009
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Provider Practice Location Address
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Address Line | 2645 SW 37TH AVE SUITE 304
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City | MIAMI
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State | FL
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Zip | 33133
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Country | US
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Telephone | 305-448-7101
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Fax | 305-442-8730
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Provider Business Mailing Address
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Address Line | 2645 SW 37TH AVE SUITE 304
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City | MIAMI
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State | FL
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Zip | 33133
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Country | US
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Telephone | 305-448-7101
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Fax | 305-442-8730
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARYANNE A. GOLDBERG
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Credential |
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Telephone | 305-448-7101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT 0003443
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License Number State | FL
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