Organization
EVOLUTION THERAPY CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERTO EDUARDO BOSCH M.T. (P)
(305) 824-6661
Entity
Organization
Contact information
Practice address
3900 NW 79TH AVE, STE 954, DORAL, FL 33166-6556
(305) 824-6661
Mailing address
3900 NW 79TH AVE, STE 954, DORAL, FL 33166-6556
(305) 824-6661
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
MA34634
FL
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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