Organization
AJ THERAPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YADENIS JIMENEZ (ADMINISTRATOR)
(813) 765-1511
Entity
Organization
Contact information
Practice address
4710 EISENHOWER BLVD STE C8, TAMPA, FL 33634-6334
(813) 402-2079
(813) 443-9942
Mailing address
6107 MEMORIAL HWY, SUITE G, TAMPA, FL 33615-4596
(813) 644-7232
(813) 443-4653
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
—
—
261Q00000X
Clinic/Center
Primary
MM31033
FL
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
09/23/2013
Last updated
10/06/2020
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