MEDICARE: NATIONAL THERAPY CENTER,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	261QP2000X	Physical Therapy Clinic/Center	MA42484	FL

General Provider Information

NPI Number	:	1386870392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL THERAPY CENTER,INC.

Provider Business Mailing Address
First Line	:	85 GRAND CANAL DR STE 408
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2571
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 GRAND CANAL DR STE 408
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2571
Country	:	US
Telephone Number	:	305-267-3484
Fax Number	:	305-267-3485

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JORGE GONZALEZ
Credential	:
Telephone Number	:	305-267-3484

Provider Enumeration Date	:	06/04/2009
Last Update Date	:	06/17/2009

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