Organization
NORTH DADE PHYSICAL THERAPY, INC.
Active
Other names
THE SPORT CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES MICHAEL SHAPIRO PT (PRESIDENT)
(954) 989-5255
Entity
Organization
Contact information
Practice address
18690 NW 2ND AVENUE, MIAMI GARDENS, FL 33169
(305) 652-2005
(305) 652-1741
Mailing address
18690 NW 2ND AVENUE, MIAMI GARDENS, FL 33169
(305) 652-2005
(305) 652-1741
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K1486
MEDICARE PTAN
FL
Enumeration date
01/24/2007
Last updated
01/08/2013
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