Organization
PREMIER PHYSICAL THERAPY LLC
Active
Other names
Physical Therapy Now Coral Gables
Organization subpart
No
Provider details
NPI number
Authorized official
DAYLIN REVILLA PTA (OWNER)
(305) 570-1666
Entity
Organization
Contact information
Practice address
2690 SW 22ND ST UNIT 3, CORAL GABLES, FL 33145-3406
(305) 570-1666
(305) 203-0546
Mailing address
2690 SW 22ND ST UNIT 3, CORAL GABLES, FL 33145-3406
(305) 570-1666
(305) 203-0546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT26790
FL
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA24456
MEDICAL LICENSE
FL
Enumeration date
08/17/2018
Last updated
02/07/2019
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