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General NPI Number Information
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NPI Number | 1649580341
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Entity Type | Organization
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Legal Business Name | CENTER FOR BALANCE, DIZZINESS AND PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 2206 S SEACREST BLVD STE 1
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-6519
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Country | US
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Telephone | 561-364-0262
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Fax | 561-364-0292
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Provider Business Mailing Address
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Address Line | 2206 S SEACREST BLVD STE 1
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-6519
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Country | US
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Telephone | 561-364-0262
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Fax | 561-364-0292
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | T RUBEN POZO
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Credential | PT
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Telephone | 561-364-0262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME84428
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License Number State | FL
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