Organization
PRESTIGE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL MORENO MA42961 (PRESIDENT)
(305) 381-5150
Entity
Organization
Contact information
Practice address
951 SW 122ND AVE, MIAMI, FL 33184-2406
(305) 381-5150
(305) 381-5150
Mailing address
951 SW 122ND AVE, MIAMI, FL 33184-2406
(305) 381-5150
(305) 381-5150
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MA42961
FL
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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