Organization
HEALTH & WELLNESS MOBILE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ODALYS PURI II LMT (OWNER)
(786) 286-9134
Entity
Organization
Contact information
Practice address
9175 SW 138TH PL, MIAMI, FL 33186-1275
(786) 286-9134
(786) 359-4237
Mailing address
9175 SW 138TH PL, MIAMI, FL 33186-1275
(786) 286-9134
(786) 359-4237
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
MA51643
FL
Other
Enumeration date
07/17/2011
Last updated
07/17/2011
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