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General NPI Number Information
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NPI Number | 1437770682
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Entity Type | Organization
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Legal Business Name | OPTIMAL HUMAN MOVEMENT
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 2631 SW 27TH ST
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City | MIAMI
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State | FL
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Zip | 33133-2239
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Country | US
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Telephone | 305-396-9002
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Fax | 305-393-9002
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Provider Business Mailing Address
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Address Line | 4640 SW 43RD AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33314-4723
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Country | US
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Telephone | 301-247-5259
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | DR. ROBERT HARRIS
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Credential | DO
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Telephone | 305-396-9002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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