Organization
SPORTZ REHAB LLC
Active
Other names
Physical Therapy Now Sunset
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DIOGO TREVISAN PT (OWNER)
(786) 286-4119
Entity
Organization
Contact information
Practice address
9767 SW 72ND ST, MIAMI, FL 33173-4615
(305) 570-1666
(305) 203-0546
Mailing address
9767 SW 72ND ST, MIAMI, FL 33173-4615
(305) 570-1666
(305) 203-0546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT31195
MEDICAL LICENSE
FL
Enumeration date
01/09/2020
Last updated
01/09/2020
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