| NPI | 1174800924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFAEL MADAN President 239-304-2471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL HCC8941) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2012-12-06 |