Organization
FORGED PERFORMANCE AND REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL URENA DPT,OCS (PHYSICAL THERAPIST/OWNER)
(321) 271-5403
Entity
Organization
Contact information
Practice address
5153 COCOPLUM AVE, MELBOURNE, FL 32940-1400
(321) 271-5403
Mailing address
5153 COCOPLUM AVE, MELBOURNE, FL 32940-1400
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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