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Organization
THERACORP
Active
Organization
THERACORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIEL FERNANDO GRULLON (OWNER)
(786) 363-3900
Entity
Organization
Contact information
Practice address
8955 SW 87TH CT, 210, MIAMI, FL 33176-2230
(786) 363-3900
Mailing address
8955 SW 87TH CT, 210, MIAMI, FL 33176-2230
(786) 363-3900
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225700000X
Massage Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/20/2009
Last updated
07/20/2009
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