Organization
GABLES INJURY & SPORTS THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEJANDRO LOPEZ (PRESIDENT)
(786) 953-8378
Entity
Organization
Contact information
Practice address
3121 PONCE DE LEON BLVD, CORAL GABLES, FL 33134-6816
(786) 953-8378
Mailing address
3121 PONCE DE LEON BLVD, CORAL GABLES, FL 33134-6816
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC9122
AHCA NUMBER
FL
Enumeration date
04/21/2011
Last updated
02/01/2012
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