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General NPI Number Information
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NPI Number | 1790445088
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Entity Type | Organization
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Legal Business Name | ETERNITY PHYSICAL THERAPEUTICS
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Dates
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Enumeration Date | 12/28/2021
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 3505 S OCEAN DR APT 507
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City | HOLLYWOOD
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State | FL
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Zip | 33019-2813
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Country | US
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Telephone | 212-785-1651
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Fax |
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Provider Business Mailing Address
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Address Line | 6951 SW 57TH ST
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City | DAVIE
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State | FL
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Zip | 33314-7000
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Country | US
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Telephone | 917-977-1550
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DARLENZY DARBOUZE
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Credential | DPT
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Telephone | 917-977-1550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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