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Organization
PARADISE PHYSICAL THERAPY
Active
Organization
PARADISE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA MICHELE AMBRIZ PT, DPT, OMPT (CEO, PT)
(956) 455-3107
Entity
Organization
Contact information
Practice address
112 E QUEEN ISABELLA, SUITE 1, PORT ISABEL, TX 78578
(956) 455-3107
Mailing address
39785 PALM DR, BAYVIEW, TX 78566-4479
(956) 455-3107
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1189508
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206938701
—
TX
Enumeration date
04/04/2017
Last updated
08/30/2017
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