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General NPI Number Information
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NPI Number | 1962806034
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Entity Type | Organization
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Legal Business Name | MOVEMENT POTENTIAL PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 18934 SW 93RD CT
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City | CUTLER BAY
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State | FL
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Zip | 33157-7954
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Country | US
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Telephone | 305-742-3125
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Fax |
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Provider Business Mailing Address
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Address Line | 18934 SW 93RD CT
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City | CUTLER BAY
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State | FL
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Zip | 33157-7954
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Country | US
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Telephone | 305-742-3125
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIM CARRERAS SCHAFFER
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Credential | MSPT
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Telephone | 305-742-3125
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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 | 19370
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License Number State | FL
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