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General NPI Number Information
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NPI Number | 1902174709
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Entity Type | Organization
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Legal Business Name | DELGARRO PHYSICAL THERAPY CENTER, CORP.
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 8040 NW 95TH ST APT 228
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2361
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Country | US
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Telephone | 305-819-1095
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Fax | 305-819-1094
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Provider Business Mailing Address
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Address Line | 8040 NW 95TH ST APT 228
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2361
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Country | US
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Telephone | 305-819-1095
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Fax | 305-819-1094
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANNELIS GARROTE
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Credential | LMT
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Telephone | 786-712-7096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | MM28078
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA62214
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License Number State | FL
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