MEDICARE: AMERICAN THERAPEUTIC ASSOCIATION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center	HCC4284	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HCC4284	OTHER	FL	AHCA

General Provider Information

NPI Number	:	1104865500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN THERAPEUTIC ASSOCIATION, INC.

Provider Business Mailing Address
First Line	:	8300 S.W. 8 STREET
Second Line	:	SUITE 105
City	:	MIAMI
State	:	FL
Zip	:	33144-4180
Country	:	US
Telephone Number	:	305-266-9549
Fax Number	:	305-266-9550

Provider Business Practice Location Address
First Line	:	8300 S.W. 8 STREET
Second Line	:	SUITE 105
City	:	MIAMI
State	:	FL
Zip	:	33144-4180
Country	:	US
Telephone Number	:	305-266-9549
Fax Number	:	305-266-9550

Authorized Official
Title or Position	:	ADMINISTRATOR OWNER
Name	:	CYNTHIA SANCHEZ
Credential	:
Telephone Number	:	305-266-9549

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	09/14/2010

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