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General NPI Number Information
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NPI Number | 1396982732
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Entity Type | Organization
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Legal Business Name | JR BENDER PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 7600 RED RD SUITE 131
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5428
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Country | US
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Telephone | 305-665-0088
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Fax | 305-665-5611
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Provider Business Mailing Address
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Address Line | 7600 RED RD SUITE 131
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5428
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Country | US
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Telephone | 305-665-0088
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Fax | 305-665-5611
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Authorized Official
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Title or Position | SOLE MEMBER MANAGER
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Name | MR. JEFFREY RAYMOND BENDER
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Credential | P.T.
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Telephone | 305-665-0088
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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 | PT18149
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License Number State | FL
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