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General NPI Number Information
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NPI Number | 1962028852
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Entity Type | Organization
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Legal Business Name | SPINE & SPORT REHAB, INC
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 9600 SW 8TH ST STE 23B
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City | MIAMI
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State | FL
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Zip | 33174-2969
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Country | US
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Telephone | 305-228-9626
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Fax | 305-228-9628
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Provider Business Mailing Address
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Address Line | 9600 SW 8TH ST STE 23B
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City | MIAMI
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State | FL
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Zip | 33174-2969
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Country | US
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Telephone | 305-228-9626
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GERARDO E REMY
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Credential | DC
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Telephone | 305-228-9626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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