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General NPI Number Information
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NPI Number | 1457150229
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Entity Type | Organization
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Legal Business Name | FLORIDA INJURY TREATMENT CENTER, LLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 3601 W COMMERCIAL BLVD # 13-14
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-3300
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Country | US
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Telephone | 656-241-9963
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 W COMMERCIAL BLVD # 13-14
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-3300
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Country | US
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Telephone | 656-241-9963
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NOEMI RIVERA
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Credential |
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Telephone | 656-241-9963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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