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Organization
PRESTIGE SPORTS AND REGENERATIVE MEDICINE LLC
Active
Organization
PRESTIGE SPORTS AND REGENERATIVE MEDICINE LLC
Active
Other names
PRESTIGE SPORTS AND REGENERATIVE MEDICINE LLC, PRESTIGE CONCIERGE PT-OT-SLP AND RT
Organization subpart
No
Provider details
NPI number
Authorized official
EMIR KHATTAK (CREDENTIALING MANAGER)
(469) 485-3166
Entity
Organization
Contact information
Practice address
3800 W BROWARD BLVD STE 101, FT LAUDERDALE, FL 33312-1018
(469) 915-4211
(954) 820-4479
Mailing address
3800 W BROWARD BLVD STE 101, FT LAUDERDALE, FL 33312-1018
(954) 787-5234
(954) 820-4479
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/07/2024
Last updated
10/14/2024
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