| NPI | 1942703244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LEA FONDA Billing/Credentialing Manager 305-517-1219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT20304) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |