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General NPI Number Information
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NPI Number | 1437589983
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Entity Type | Organization
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Legal Business Name | OVER THE RAINBOW THERAPY
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Dates
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Enumeration Date | 11/20/2013
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 14435 SW 96TH AVE
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City | MIAMI
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State | FL
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Zip | 33176-7814
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Country | US
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Telephone | 305-807-7566
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Fax | 305-253-7469
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Provider Business Mailing Address
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Address Line | 14435 SW 96TH AVE
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City | MIAMI
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State | FL
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Zip | 33176-7814
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Country | US
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Telephone | 305-807-7566
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Fax | 305-253-7469
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANNABELLE J. MONTERO
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Credential | MSPT
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Telephone | 305-807-7566
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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 | 22127
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License Number State | FL
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