=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477314912
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JUST PT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2024
-----------------------------------------------------
Last Update Date | 03/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6090 SW 40TH ST FL 2
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33155-5252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-709-1001
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9100 S DADELAND BLVD STE 1400
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33156-7816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-614-7740
-----------------------------------------------------
Fax | 305-517-1019
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MGR
-----------------------------------------------------
Name | PETER RODRIGUEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-709-1001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------