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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