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General NPI Number Information
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NPI Number | 1316257470
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Entity Type | Organization
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Legal Business Name | EXTRA CARE MEDICAL CENTER INC
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Dates
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Enumeration Date | 10/07/2010
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Last Update Date | 03/15/2013
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Provider Practice Location Address
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Address Line | 4908 SW 72ND AVE SUITE A
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City | MIAMI
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State | FL
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Zip | 33155-5548
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Country | US
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Telephone | 305-662-4646
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Fax | 305-662-4656
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Provider Business Mailing Address
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Address Line | 7262 SW 48TH ST SUITE A
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City | MIAMI
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State | FL
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Zip | 33155-5525
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Country | US
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Telephone | 305-662-4646
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Fax | 305-662-4656
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALAIN DIAZ
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Credential |
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Telephone | 305-662-4646
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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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