| NPI | 1396460697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELL PAVONI Owner 305-432-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2023-03-27 |