MEDICARE: PERFORMANCE MEDICAL 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

General Provider Information

NPI Number	:	1700932159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFORMANCE MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	1257 W 44TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3331
Country	:	US
Telephone Number	:	305-826-6689
Fax Number	:	305-826-1299

Provider Business Practice Location Address
First Line	:	1257 W 44TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3331
Country	:	US
Telephone Number	:	305-826-6689
Fax Number	:	305-826-1299

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ISABEL C NARANJO
Credential	:
Telephone Number	:	305-826-6689

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	08/22/2020

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