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Organization
SPARTAKUS CENTER CORP
Active
Organization
SPARTAKUS CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR NODARSE LMT (PRESIDENT)
(305) 625-7719
Entity
Organization
Contact information
Practice address
5190 NW 167TH ST, SUITE 108, MIAMI GARDENS, FL 33014-6328
(305) 625-7719
(305) 625-7720
Mailing address
5190 NW 167TH ST, SUITE 108, MIAMI GARDENS, FL 33014-6328
(305) 625-7719
(305) 625-7720
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9110
AHCA
FL
Enumeration date
09/28/2011
Last updated
09/28/2011
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