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General NPI Number Information
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NPI Number | 1720501141
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Entity Type | Individual
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Provider Name | SARAH ROSE GLICK DPT
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Gender | Female
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1475 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1002
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Country | US
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Telephone | 305-243-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 185 SE 14TH TER APT 906
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City | MIAMI
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State | FL
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Zip | 33131-3415
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Country | US
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Telephone | 847-691-6047
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PT32707
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License Number State | FL
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