Individual
MICHAEL EFREM GUBIEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
11870 W STATE ROAD 84, DAVIE, FL 33325-3816
(954) 474-3611
Mailing address
10941 NW 59TH ST, DORAL, FL 33178-2815
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
23459
FL
261QP2000X
Physical Therapy Clinic/Center
23459
FL
Other
Enumeration date
07/31/2012
Last updated
04/18/2013
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