Organization
ELITE THERAPY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGALY CONSUEGRA (PRESIDENT)
(305) 512-0006
Entity
Organization
Contact information
Practice address
4184 W 12TH AVE, HIALEAH, FL 33012-4158
(305) 512-0006
Mailing address
4184 W 12TH AVE, HIALEAH, FL 33012-4158
(305) 512-0006
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
07/08/2006
Last updated
08/22/2020
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