Individual
DIMAS WONGSOPAWIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
540 NE 162ND ST, NORTH MIAMI BEACH, FL 33162-4357
(305) 450-4557
Mailing address
540 NE 162ND ST, NORTH MIAMI BEACH, FL 33162-4357
(305) 450-4557
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
31097
FL
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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