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General NPI Number Information
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NPI Number | 1841318136
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Entity Type | Organization
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Legal Business Name | MPT SERVICES INC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 3493 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33013-3052
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Country | US
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Telephone | 305-691-0704
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Fax | 305-691-0230
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Provider Business Mailing Address
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Address Line | 3493 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33013-3052
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Country | US
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Telephone | 305-691-0704
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Fax | 305-691-0230
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARTHA C ACERO-VEGA
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Credential | R.P.T.
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Telephone | 786-326-8905
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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 | PT10731
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License Number State | FL
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