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General NPI Number Information
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NPI Number | 1790984995
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Entity Type | Organization
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Legal Business Name | NEW ALTERNATIVE THERAPY CENTER, LLC
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 7705 NW 48TH ST SUITE 120
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City | DORAL
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State | FL
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Zip | 33166-5454
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Country | US
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Telephone | 305-418-3117
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Fax |
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Provider Business Mailing Address
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Address Line | 7705 NW 48TH ST
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City | DORAL
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State | FL
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Zip | 33166-5454
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Country | US
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Telephone | 305-418-3117
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. ELVIS E CALDERON
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Credential |
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Telephone | 305-510-4279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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