Organization
ACTIVE PT SVCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISETTE PORTES PT (PRESIDENT)
(305) 332-9821
Entity
Organization
Contact information
Practice address
3115 SW 98TH CT, MIAMI, FL 33165-2954
(305) 332-9821
(305) 229-6095
Mailing address
3115 SW 98TH CT, MIAMI, FL 33165-2954
(305) 332-9821
(305) 229-6095
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT21988
FL
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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