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General NPI Number Information
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NPI Number | 1760839955
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Entity Type | Organization
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Legal Business Name | RESTORATIVE THERAPY CENTER INC
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 05/18/2016
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Provider Practice Location Address
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Address Line | 2272 SW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33135-3112
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Country | US
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Telephone | 786-542-8487
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Fax | 786-542-8620
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Provider Business Mailing Address
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Address Line | 2272 SW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33135-3112
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Country | US
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Telephone | 786-542-8487
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Fax | 786-542-8620
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Authorized Official
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Title or Position | OWNER
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Name | MR. RANDY DIAZ
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Credential |
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Telephone | 786-542-8487
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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 |
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License Number State |
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