MEDICARE: MIGUEL SALAS PTA

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	225200000X	Physical Therapy Assistant	PTA27246	FL

General Provider Information

NPI Number	:	1386182319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL SALAS PTA

Provider Business Mailing Address
First Line	:	2236 NW 59TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-7822
Country	:	US
Telephone Number	:	786-506-2901
Fax Number	:

Provider Business Practice Location Address
First Line	:	2236 NW 59TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-7822
Country	:	US
Telephone Number	:	786-506-2901
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2017
Last Update Date	:	02/10/2017

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Directions to “ MIGUEL SALAS PTA” Practice Location

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