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General NPI Number Information
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NPI Number | 1881115731
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Entity Type | Organization
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Legal Business Name | PURE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 06/30/2017
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Provider Practice Location Address
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Address Line | 22 MERRICK WAY
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City | CORAL GABLES
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State | FL
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Zip | 33134-5307
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Country | US
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Telephone | 305-912-5775
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Fax |
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Provider Business Mailing Address
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Address Line | 1172 S DIXIE HWY # 271
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City | CORAL GABLES
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State | FL
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Zip | 33146-2918
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AUSTIN MISIURA
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Credential |
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Telephone | 305-469-2598
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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 |
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License Number State |
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