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Organization
MAYA PHYSICAL THERAPY, INC
Active
Organization
MAYA PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAIMON K NADUPARAMBIL PT (PRESIDENT)
(954) 274-0415
Entity
Organization
Contact information
Practice address
5745 S UNIVERSITY DR, DAVIE, FL 33328-6114
(954) 252-9619
(954) 252-9620
Mailing address
4022 TURQUOISE TRL, WESTON, FL 33331-3182
(954) 252-9619
(954) 252-9620
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT19750
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004243200
—
FL
Enumeration date
08/16/2010
Last updated
02/08/2013
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