Therapy Sport Medical Corp | |
6555 Nw 36th St Suite 214 Virginia Gardens FL 33166-6978 | |
(305) 526-8229 | |
(305) 526-8230 |
Full Name | Therapy Sport Medical Corp |
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Speciality | General Practice |
Location | 6555 Nw 36th St, Virginia Gardens, Florida |
Authorized Official Name and Position | Hisela M Castro (PRESIDENT) |
Authorized Official Contact | 3055268229 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Therapy Sport Medical Corp 6555 Nw 36th St Suite 214 Virginia Gardens FL 33166-6978 Ph: (305) 526-8229 | Therapy Sport Medical Corp 6555 Nw 36th St Suite 214 Virginia Gardens FL 33166-6978 Ph: (305) 526-8229 |
NPI Number | 1023392297 |
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Provider Enumeration Date | 10/05/2011 |
Last Update Date | 10/05/2011 |
Identifier | Type | State | Issuer |
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1023392297 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | HCC9145 (Florida) | Primary |
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