Organization
BRIDGE OF HOPE CENTRAL FLORIDA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HECTOR L RODRIGUEZ AB (PRESIDENT)
(407) 575-4636
Entity
Organization
Contact information
Practice address
2955 CORAL WAY, 1821 SW 27TH AVE, CORAL GABLES, FL 33145-3205
(407) 575-4636
(407) 343-5599
Mailing address
PO BOX 452878, KISSIMMEE, FL 34745-2878
(407) 575-4636
(407) 343-5599
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT15334
FL
225X00000X
Occupational Therapist
OT15902
FL
235Z00000X
Speech-Language Pathologist
Primary
SA11401
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000867502
—
FL
05
—
000867506
—
FL
Enumeration date
04/28/2016
Last updated
05/02/2016
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