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General NPI Number Information
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NPI Number | 1275919813
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Entity Type | Individual
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Provider Name | MATVEY GORZHEVSKY PT
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Gender | Male
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 08/13/2016
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Provider Practice Location Address
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Address Line | 3575 NE 207TH ST STE B17
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City | AVENTURA
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State | FL
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Zip | 33180-3705
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Country | US
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Telephone | 305-306-8376
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Fax |
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Provider Business Mailing Address
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Address Line | 3575 NE 207TH ST STE B17
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City | AVENTURA
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State | FL
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Zip | 33180-3705
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Country | US
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Telephone | 305-306-8376
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT30534
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License Number State | FL
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