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General NPI Number Information
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NPI Number | 1285091942
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Entity Type | Organization
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Legal Business Name | SOS PHYSIO LLC
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 12/17/2025
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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 | 305-306-8373
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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 | 305-306-8373
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATVEY GORZHEVSKY
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Credential |
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Telephone | 305-306-8376
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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 | PT30534
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License Number State | FL
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