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Organization
NEW FORM PHYSICAL THERAPY AND WELLNESS CENTER P.A.
Active
Organization
NEW FORM PHYSICAL THERAPY AND WELLNESS CENTER P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SIMONE SALLES PT, MSPT, DPT (PHYSICAL THERAPIST)
(305) 766-4181
Entity
Organization
Contact information
Practice address
17971 BISCAYNE BLVD STE 104, AVENTURA, FL 33160-2531
(305) 999-1844
Mailing address
PO BOX 800625, AVENTURA, FL 33280-0625
(305) 766-4181
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23183
FL
Other
Enumeration date
11/23/2015
Last updated
09/01/2023
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