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NPI Code Detail

MEDICARE: USA SPORTS MEDICINE LLC

MEDICARE: USA SPORTS MEDICINE LLC
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
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1639700370
Entity Type Code : Organization
Provider Name (Legal Business Name) : USA SPORTS MEDICINE LLC
Provider Business Mailing Address
First Line : 404 WASHINGTON AVE STE 120
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-6651
Country : US
Telephone Number : 305-395-9599
Fax Number : 305-932-5612
Provider Business Practice Location Address
First Line : 404 WASHINGTON AVE STE 120
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-6651
Country : US
Telephone Number : 305-395-9599
Fax Number : 305-932-5612
Authorized Official
Title or Position : AO/PROVIDER
Name : DR. MATTHEW COOPER
Credential : DC
Telephone Number : 305-935-9599
Provider Enumeration Date : 01/31/2020
Last Update Date : 01/31/2020

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Directions to “USA SPORTS MEDICINE LLC ” Practice Location

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