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General NPI Number Information
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NPI Number | 1912765561
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Entity Type | Organization
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Legal Business Name | DELTA PERFORMANCE AND REHAB, LLC
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 200 SW 172ND AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-1517
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Country | US
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Telephone | 754-233-3907
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Fax |
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Provider Business Mailing Address
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Address Line | 8850 NW 151ST ST
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City | MIAMI LAKES
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State | FL
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Zip | 33018-1320
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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 | PHYSICAL THERAPIST
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Name | MICHAEL HERNANDEZ
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Credential | DPT
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Telephone | 786-227-0752
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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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