| Lavender Physical Therapy & Wellness, Llc | |
|
9461 Sw 119th Ct Miami FL 33186-2007 | |
| (305) 401-2105 | |
| Not Available |
| Full Name | Lavender Physical Therapy & Wellness, Llc |
|---|---|
| Speciality | Physical Therapist |
| Location | 9461 Sw 119th Ct, Miami, Florida |
| Authorized Official Name and Position | Erika Lopez (OWNER) |
| Authorized Official Contact | 3054012105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavender Physical Therapy & Wellness, Llc 9461 Sw 119th Ct Miami FL 33186-2007 Ph: () - | Lavender Physical Therapy & Wellness, Llc 9461 Sw 119th Ct Miami FL 33186-2007 Ph: (305) 401-2105 |
| NPI Number | 1891563243 |
|---|---|
| Provider Enumeration Date | 12/14/2023 |
| Last Update Date | 12/14/2023 |
| Medicare PECOS PAC ID | 3577916287 |
|---|---|
| Medicare Enrollment ID | O20240130001035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891563243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Erika Nicole Lopez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336693548 PECOS PAC ID: 5294023214 Enrollment ID: I20230622001251 |
| Provider Name | Nicole Cassandra Fernandez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356970479 PECOS PAC ID: 9133562895 Enrollment ID: I20240209000510 |
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