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General NPI Number Information
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NPI Number | 1508208513
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Entity Type | Organization
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Legal Business Name | APOLLO REHAB
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 9905 NW 79TH AVE
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2405
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Country | US
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Telephone | 786-877-9416
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Fax |
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Provider Business Mailing Address
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Address Line | 18840 NW 57TH AVE APT 306
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City | HIALEAH
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State | FL
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Zip | 33015-7027
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Country | US
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Telephone | 786-877-9416
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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 | ZEUS MEDINA VERA
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Credential | DPT
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Telephone | 786-877-9416
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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 | PT25873
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License Number State | FL
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