Organization
SHORES THERAPY, LLC
Active
Other names
Glades Therapy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIA HEREDIA MPT (DIRECTOR OF THERAPY)
(305) 588-4210
Entity
Organization
Contact information
Practice address
358 NE 105TH ST, MIAMI SHORES, FL 33138-2022
(305) 588-4210
Mailing address
358 NE 105TH ST, MIAMI SHORES, FL 33138-2022
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487766689
PERSONAL NPI
FL
Enumeration date
03/05/2018
Last updated
03/05/2018
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