MEDICARE: JOSUZO CORP

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

General Provider Information

NPI Number	:	1689405169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSUZO CORP

Provider Business Mailing Address
First Line	:	9690 W SAMPLE RD STE 202
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4053
Country	:	US
Telephone Number	:	954-775-0220
Fax Number	:

Provider Business Practice Location Address
First Line	:	9690 W SAMPLE RD STE 202
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4053
Country	:	US
Telephone Number	:	954-775-0220
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUTHORIZED OFFICIAL
Name	:	JOSE ANTONIO DOMINGUEZ
Credential	:
Telephone Number	:	954-775-0220

Provider Enumeration Date	:	08/08/2024
Last Update Date	:	01/15/2025

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Directions to “JOSUZO CORP ” Practice Location

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