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Organization
THERAPY SPORT MEDICAL CORP
Active
Organization
THERAPY SPORT MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HISELA M CASTRO (PRESIDENT)
(305) 526-8229
Entity
Organization
Contact information
Practice address
6555 NW 36TH ST, SUITE 214, VIRGINIA GARDENS, FL 33166-6978
(305) 526-8229
(305) 526-8230
Mailing address
6555 NW 36TH ST, SUITE 214, VIRGINIA GARDENS, FL 33166-6978
(305) 526-8229
(305) 526-8230
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
HCC9145
FL
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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