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General NPI Number Information
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NPI Number | 1992136857
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Entity Type | Organization
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Legal Business Name | ADVANCE THERAPY & REHAB CENTER INC
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 221 MAJORCA AVE APT 4
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City | CORAL GABLES
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State | FL
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Zip | 33134-4434
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Country | US
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Telephone | 305-582-1593
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Fax | 786-228-4941
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Provider Business Mailing Address
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Address Line | 221 MAJORCA AVE APT 4
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City | CORAL GABLES
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State | FL
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Zip | 33134-4434
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Country | US
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Telephone | 305-582-1593
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Fax | 786-228-4941
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICARDO ORTEGA
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Credential |
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Telephone | 305-582-1593
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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 | 21975 HCC939
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License Number State | FL
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