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General NPI Number Information
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NPI Number | 1487942595
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Entity Type | Organization
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Legal Business Name | SCOLIOSIS PT
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 1000 S DIXIE HWY
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-7044
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Country | US
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Telephone | 954-458-5700
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Fax | 954-458-5110
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Provider Business Mailing Address
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Address Line | 9761 NW 58TH CT
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City | PARKLAND
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State | FL
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Zip | 33076-1830
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Country | US
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Telephone | 954-796-4044
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Fax | 954-757-7699
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Authorized Official
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Title or Position | OWNER
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Name | DORI L RUBIN
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Credential | PT
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Telephone | 954-796-4044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT3501
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License Number State | FL
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