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General NPI Number Information
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NPI Number | 1811245368
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Entity Type | Organization
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Legal Business Name | INTENTION WELLNESS INC., PHYSICAL THERAPY SERVICES
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 15207 SW 176TH LN
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City | MIAMI
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State | FL
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Zip | 33187-1620
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Country | US
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Telephone | 305-209-5050
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Fax | 305-235-5050
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Provider Business Mailing Address
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Address Line | 15207 SW 176TH LN
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City | MIAMI
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State | FL
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Zip | 33187-1620
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Country | US
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Telephone | 305-209-5050
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Fax | 305-235-5050
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | LOURDES M PALMER
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Credential | PT
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Telephone | 305-209-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT17965
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License Number State | FL
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