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General NPI Number Information
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NPI Number | 1285337402
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Entity Type | Organization
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Legal Business Name | JEM'S PHYSICAL THERAPY & WELLNESS LLC
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 07/01/2023
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Provider Practice Location Address
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Address Line | 633 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-6043
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Country | US
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Telephone | 305-300-9613
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Fax |
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Provider Business Mailing Address
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Address Line | 18445 SW 267TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33031-2239
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Country | US
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Telephone | 305-300-9613
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEMMA ROSE LOPEZ
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Credential | PT, DPT, CLT
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Telephone | 305-300-9613
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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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