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General NPI Number Information
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NPI Number | 1831326149
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Entity Type | Organization
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Legal Business Name | BACK TO FUNCTION INC
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 2640 SW 25TH ST
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City | MIAMI
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State | FL
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Zip | 33133-2211
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Country | US
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Telephone | 786-553-0104
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Fax |
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Provider Business Mailing Address
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Address Line | 2640 SW 25TH ST
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City | MIAMI
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State | FL
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Zip | 33133-2211
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Country | US
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Telephone | 786-553-0104
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. EMMA GALTES
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Credential | OTR/L MHSC
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Telephone | 786-553-0104
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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 10913
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 6399
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License Number State | FL
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