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Organization

BLUE MILLENIUM REHABILITATION, INC.

Active
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Organization

BLUE MILLENIUM REHABILITATION, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JUAN FERNANDO LOPEZ L.M.T (PRESIDENT)
30054567798
Entity
Organization

Contact information

Practice address
7911 NW 72ND AVE STE 103B, MEDLEY, FL 33166-2226
(305) 456-7798
Mailing address
7911 NW 72ND AVE STE 103B, MEDLEY, FL 33166-2226
(305) 456-7798

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
MM27251

Other

Enumeration date
07/12/2011
Last updated
07/12/2011
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