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General NPI Number Information
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NPI Number | 1891805396
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Entity Type | Organization
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Legal Business Name | QUALITY CARE THERAPY SERVICE
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10342 WELLEBY ISLES BLVD
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City | SUNRISE
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State | FL
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Zip | 33351-8291
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Country | US
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Telephone | 954-401-7413
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Fax |
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Provider Business Mailing Address
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Address Line | 10342 WELLEBY ISLES BLVD
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City | SUNRISE
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State | FL
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Zip | 33351-8291
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Country | US
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Telephone | 954-401-7413
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH A GANDOLFO
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Credential | RPT
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Telephone | 954-401-7419
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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 | PT21833
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License Number State | FL
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