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General NPI Number Information
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NPI Number | 1740017300
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Entity Type | Individual
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Provider Name | LAURA JEANNE MICALI MSPT
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Gender | Female
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 7232 SW 39TH TER
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City | MIAMI
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State | FL
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Zip | 33155-6624
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Country | US
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Telephone | 786-409-3254
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Fax |
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Provider Business Mailing Address
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Address Line | 7783 SW 192ND ST
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City | CUTLER BAY
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State | FL
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Zip | 33157-8050
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Country | US
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Telephone | 786-368-7771
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-0010269
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License Number State | FL
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